- 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
- 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
- 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
- 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
- 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
- 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
- Molina Healthcare (Columbus, OH)
- …to navigate online portals and databases. **Preferred Qualifications** * Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), ... **JOB DESCRIPTION** **Job Summary** This position will be focused on Clinical Program Design. Provides subject matter expertise and leadership to healthcare services… more
- 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
- Highmark Health (Columbus, OH)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Molina Healthcare (Columbus, OH)
- …be required (dependent upon state/contractual requirements). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed ... suggest changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and… more
- 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
- 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
- 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
- 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
- Elevance Health (Columbus, OH)
- **LTSS Service Coordinator - Clinician ( Case Manager )** **Hiring near Columbus, OH** **Location** : This field-based role enables associates to primarily operate ... competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.… more
- 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
- 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