• Clinical Case Manager

    CVS Health (Columbus, OH)
    …treatment/services. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, ... such as ambulatory care or outpatient clinic/facility. + Active and unrestricted Independent Behavioral Health clinical license in the state of Ohio. ( Ex… more
    CVS Health (11/08/25)
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  • Care Manager , Telephonic Behavioral

    Humana (Columbus, OH)
    …Licensed Masters Social Worker (LMSW-ACP), Clinical Psychologist** with; + Clinical experience in: pediatrics, behavioral health, and/or ASD; a healthcare ... and Family Therapist (LCMFT), Licensed Mental Health Counselor (LMHC)** with; + Clinical experience in: pediatrics, behavioral health, and/or ASD; a healthcare… more
    Humana (11/07/25)
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  • Sr. Clinical Consultant Social Worker…

    OhioHealth (Columbus, OH)
    …for individuals from at-risk populations from interdisciplinary team members (including physicians, Case Managers, staff nurses and other members of the care team). ... responsibilities for scheduling staff, daily assigning of cases, and assisting the manager with direct supervision of the social work staff and masters level… more
    OhioHealth (09/18/25)
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  • Telephonic Nurse Case Manager

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Telephonic Nurse Case Manager will be a member of the In-Home Case Management Team, ... case management throughout the continuum of care. The case manager will offer guidance, support, and...beneficiary's capacity for self- care, to cost-effectively achieve desired clinical outcomes and to enhance quality of medical care.… more
    Humana (11/06/25)
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  • Medical Director, Behavioral Health (NE)

    Molina Healthcare (Columbus, OH)
    …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... to provide quality and cost-effective member care. Essential Job Duties * Provides behavioral health oversight and clinical leadership for health plan and/or… more
    Molina Healthcare (11/09/25)
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  • Case Manager , Registered Nurse…

    CVS Health (Columbus, OH)
    …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
    CVS Health (11/07/25)
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  • Field Nurse - Nurse Case Manager II

    Elevance Health (Columbus, OH)
    **Field Nurse - Nurse Case Manager II** **Work location:** This field-based role located in the Columbus, OH area enables associates to primarily operate in the ... 9am to 5:30pm EST The **Field Nurse - Nurse Case Manager II** is responsible for care...+ Coordinate referrals to local and statewide resources including behavioral health, housing, transportation, and food assistance. + Partner… more
    Elevance Health (10/22/25)
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  • Case Manager

    AmeriHealth Caritas (Dublin, OH)
    **Role Overview:** The Care Manager supports maternity members through personalized care coordination and case management, helping them achieve optimal health ... ; **Responsibilities:** + Assess members to determine care coordination and case management needs for all referred members.; + Completes comprehensive… more
    AmeriHealth Caritas (10/03/25)
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  • Program Manager , Healthcare Services…

    Molina Healthcare (Columbus, OH)
    …to navigate online portals and databases. **Preferred Qualifications** + Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), ... **Required Qualifications** + At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of… more
    Molina Healthcare (10/10/25)
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  • RN Care Manager - Community Well

    Molina Healthcare (Delaware, OH)
    …must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and ... and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are… more
    Molina Healthcare (11/03/25)
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  • RN Care Manager - Waiver Program

    Molina Healthcare (Columbus, OH)
    …directly with individuals with substance use disorders. Preferred Qualifications * Certified Case Manager (CCM). * Experience working with populations that ... members on Waiver program. This position will have a case load and manage members enrolled in this program....accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS)… more
    Molina Healthcare (10/31/25)
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  • Care Plan Reviewer- OhioRISE

    CVS Health (Columbus, OH)
    …do it all with heart, each and every day. **Position Summary** The Care Plan Reviewer ( Clinical Case Manager BH) utilizes advanced clinical judgment and ... and begin to identify comprehensive member needs. **Required Qualifications** . Unencumbered Behavioral Health clinical license in Ohio is required (LMFT, LSW,… more
    CVS Health (10/24/25)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Columbus, OH)
    …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case /utilization management and/or disease/condition management experience, or… more
    Highmark Health (11/06/25)
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  • National Accounts Medical Director

    Elevance Health (Columbus, OH)
    …director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance to account reporting ... medical policies used for operational reviews. + Leading multidisciplinary rounds for case management /complex clinical management. + Peer-to-peer outreach for… more
    Elevance Health (09/23/25)
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  • PCO Medical Director- UM - Full Time

    CenterWell (Columbus, OH)
    …and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization… more
    CenterWell (11/06/25)
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  • LTSS Service Coordinator - Clinician (LSW, LCSW,…

    Elevance Health (Columbus, OH)
    **LTSS Service Coordinator - Clinician ( Case Manager )** **Hiring near Ashland, Bucyrus, Columbus, Chillicothe, Hillsboro, Ironton, Mansfield, Marion, Mount Orab, ... competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.… more
    Elevance Health (11/07/25)
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  • Healthcare Consultant II

    Adecco US, Inc. (Columbus, OH)
    …lives across Clinton, Clermont, and Hamilton Counties. **Position Details** **Title:** Case Manager , Licensed Social Worker (LSW) **Location:** Must reside ... impact in your community? Join My Care of Ohio's Case Management Team and use your clinical ...good standing (State of Ohio) + 3+ years of behavioral health or social work experience + Strong communication,… more
    Adecco US, Inc. (10/22/25)
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  • Disease Management Nurse - Remote

    Sharecare (Columbus, OH)
    …helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... A Disease Management Nurse is supervised by an Operations Manager (OM). All Sharecare clinicians are required to participate...during the training period will be evaluated on a case by case basis and must be… more
    Sharecare (10/22/25)
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