- 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
- Elevance Health (Columbus, OH)
- ** Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical ... (EST) business hours with** **some weekends based upon organizational/business needs.** The ** Behavioral Health Care Manager II** is responsible for managing… 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
- 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 (Columbus, OH)
- …services. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Active and unrestricted Certified Case Manager (CCM) Active, unrestricted State Nursing license ... members on Waiver program. This position will have a case load and manage members enrolled in this program....an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… 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
- 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
- Elevance Health (Worthington, OH)
- **LTSS Service Coordinator ( Case Manager )** **Hiring near Akron, Cambridge, Canton, Colerain, Columbus, Chillicothe, Coschocton, Cuyahoga Falls, Deerfield, ... competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.… 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
- National Youth Advocate Program (Columbus, OH)
- …Tuition Assistance, and **Work Anniversary Trips** ! **Position Overview** **Summary** The Clinical Services Manager assists the Director of Service Reception to ... vision, and values while providing leadership to the clinical supervisor and clinical therapists on case consultation with the development and growth of … more
- 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 (Columbus, OH)
- …State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in ... in case , disease or utilization management; managed care; or medical/ behavioral health settings. + One year of training delivery experience, including adult… more
- Molina Healthcare (Columbus, 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 ... health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If… 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
- Elevance Health (Worthington, OH)
- …office visits with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering ... person_ _‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ The… 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
- Elevance Health (Columbus, OH)
- **LTSS Concierge Coordinator ( Case Manager )** **Hiring statewide across Ohio** **This position is primarily virtual but may require you to work in the field ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (Worthington, OH)
- **LTSS Service Coordinator - Clinician ( Case Manager )** **Hiring near Akron, Cambridge, Canton, Colerain, Columbus, Chillicothe, Coschocton, Cuyahoga Falls, ... competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.… more
- Elevance Health (Columbus, OH)
- …_‐_ _centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ **Medical ... ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or… more