- St. Luke's University Health Network (Bucks, OH)
- …who may require treatment with seclusion/restraints. + Supports the function of utilization management regarding pre-certification process for all intakes and ... mental health/crisis intervention experience required. Previous experience with case management / utilization review and managed care models preferred. Please… more
- CVS Health (Columbus, OH)
- …required. Preferred Qualifications + Crisis intervention skills preferred. + Managed care/ utilization review experience preferred. + Case management and ... thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider… more
- BrightSpring Health Services (Canton, OH)
- …all nursing personnel, and ensure care and services are coordinated with behavioral and programmatic staff in partnership with the Executive Director. The Director ... of business development & growth, achievement of key performance indicators, management of nursing performance and staff development. Responsibilities * Oversees and… more
- Elevance Health (Mason, OH)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance...+ Requires MA/MS social work counseling or a related behavioral health field or a degree in nursing, and… more
- Elevance Health (Cincinnati, OH)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance...+ MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and… more
- CenterWell (Columbus, OH)
- …Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as ... ER visits, readmissions, total cost of care, and reducing acute care utilization ). * Familiarity in integrated care management programs with primary… more
- Ford Motor Company (Columbus, OH)
- …is best-in-class. **In this position ** The Accessories eCommerce Merchandising Manager is responsible for deeply understanding customer needs and optimizing the ... business value daily by pulling, analyzing, and translating web analytics and behavioral data into actionable insights to enhance sales, conversion, and customer… more
- Cerelia Bakery Canada LP (Whitehall, OH)
- …leader. Position Summary We are looking for an experienced Production Manager that provides manufacturing leadership to deliver superb products that meet ... achieving safety, quality, sanitation, productivity, and cost targets. The Production Manager will create and sustain a nurturing environment that empowers,… more
- Walmart (Groveport, OH)
- …areas of opportunity; developing and implementing process changes; implementing utilization and effectiveness of quality assurance programs; evaluating service level ... data in order to determine behavioral gaps and training needs; and collaborating with key...to motivate, influence, and inspire commitment and action. Talent Management * Creates a discipline and focus around developing… more
- Cleveland Clinic (Cleveland, OH)
- …level. + Actively seeks opportunities for the highest utilization of bed management and advocates with behavioral health unit nursing leadership on behalf of ... healthcare organizations in the world. Psychiatric Crisis Specialists are members of the Behavioral Health Intake team and are responsible for the through put of all… more
- CenterWell (Columbus, OH)
- …health and full-risk frameworks, including patient engagement, clinical professional skillsets, utilization management , care management , clinical information ... the complex needs of seniors and improve health outcomes and avoidable utilization (eg, palliative care, post-acute care, transitions of care) at a population… more
- Elevance Health (Cincinnati, OH)
- …role required by a State agency. **Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience is a plus. + Ability to meet necessary ... **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective… more
- Highmark Health (Columbus, OH)
- …terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- Elevance Health (Mason, OH)
- …The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- CenterWell (Columbus, OH)
- …optimal patient care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and serve as a national clinical program leader ... This role reports to the National Director, High Risk Patient Management . Responsibilities will include: + Lead comprehensive clinical pharmacy service development,… more
- Highmark Health (Columbus, OH)
- …performance and compliance monitoring. This position will continuously engage Procurement Management to review performance and key performance indicators and take a ... functional business clients to drive best practice adoption, optimized system utilization and continuous process improvement outcomes. + Develop and maintain… more
- Sharecare, Inc. (Columbus, OH)
- …other members of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality ... with the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations … more
- ProMedica Health System (Toledo, OH)
- …family members, schools, court staff, attorneys, and case managers. Participates in utilization management activities as needed (as required for reimbursement of ... including mental health, medical, financial, and legal sources, represents outpatient behavioral health services in such networks. Assist clients in identifying and… more
- CVS Health (Columbus, OH)
- …- Advanced care planning experience - Hospice/palliative care experience - Case management and discharge planning experience - Managed care/ utilization review ... our customers and members. This role partners with a registered nurse case manager to utilize a collaborative process of assessment, planning, and advocacy to meet… more
- Somatus (Toledo, OH)
- …with local leadership and/or provider engagement to build relationships with case management teams at strategic facilities in assigned area as identified by the ... Operations Manager , provide information and education on Somatus program benefits...The Hospital Liaison will work with the RNCM, case management and care givers to identify barriers in safe… more