- Elevance Health (Columbus, OH)
- …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... **LTSS Service Coordinator - Clinician (Case Manager)** **Hiring near Columbus, OH** **Location**...person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial… more
- Highmark Health (Columbus, OH)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Molina Healthcare (Columbus, OH)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT… more
- Molina Healthcare (Columbus, OH)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Behavioral Health nursing experience- inpatient psychiatric, IMD, Residential SUD,… more