• Utilization Management

    CVS Health (Columbus, OH)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
    CVS Health (11/01/25)
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  • LTSS Service Coordinator - Clinician (LSW,…

    Elevance Health (Dublin, 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 Cambridge, Canton, Columbus,...person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial… more
    Elevance Health (10/13/25)
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  • Utilization Management Clinical…

    CVS Health (Columbus, OH)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (10/26/25)
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  • Care Review Clinician , PA (RN)

    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 (10/18/25)
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  • Care Review Clinician (RN)

    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
    Molina Healthcare (10/25/25)
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