- CVS Health (Columbus, OH)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Columbus, OH)
- …Mon-Fri 10:30AM-7PM with alternate weekends and holidays **Position Summary:** UM Nurse Consultant Utilizes clinical experience and skills in a collaborative ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** - 2+ years of… more
- CVS Health (Columbus, OH)
- …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... adult med surg or specialty area + Managed Care experience preferred, especially Utilization Management + preference for those residing in EST zone **Education**… more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... it all with heart, each and every day. **Position Summary** + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- Elevance Health (Columbus, OH)
- ** Utilization Management Medical Director- NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... Alternate locations may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May be… more
- CVS Health (Columbus, OH)
- …+ Human Resource and/or Supervisory experience. + Case management , Utilization Review, or Utilization Management background preferred. **Education** ... Friday, 11:00 am to 8:00 pm Eastern Time.** The Consultant provides management consultation to corporate clients...clinical assessments and triage into care. Performs case management across scope of all types of management… more
- Highmark Health (Columbus, OH)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… more