• Utilization Management

    CVS Health (Columbus, OH)
    … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent… more
    CVS Health (10/15/25)
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  • Utilization Management Appeals Nurse…

    CVS Health (Columbus, OH)
    …resolving clinical complaints and appeals by reviewing medical records and applying clinical guidelines for Utilization Management group. This RN must be ... high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our...3+ years Utilization Management or Utilization Review experience. + 3+ years clinical more
    CVS Health (10/12/25)
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  • Utilization Management Nurse…

    CVS Health (Columbus, OH)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... it all with heart, each and every day. **Position Summary** + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
    CVS Health (10/15/25)
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  • Medical Economics Consultant (Pop Health/…

    Molina Healthcare (Columbus, OH)
    …the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position ... analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for… more
    Molina Healthcare (10/16/25)
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  • Consultant , Nurse Disability I

    Lincoln Financial (Columbus, OH)
    …a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for ... industry experience preferred * Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or… more
    Lincoln Financial (10/10/25)
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  • Sr. Consultant , Nuclear Product Sales…

    Cardinal Health (Columbus, OH)
    …a highly regulated industry + Previous sales experience selling to physicians, clinical end-users, materials management , and C-suite desired + Strong preference ... Job Description **Senior Consultant , Product Sales Specialist - NPHS** **The territory covers Indiana, Michigan, Ohio, Kentucky, Missouri** The Product Sales… more
    Cardinal Health (09/25/25)
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  • Pharmacy Benefit Consultant

    Highmark Health (Columbus, OH)
    …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
    Highmark Health (08/26/25)
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  • Reimbursement Solutions Analyst

    Cardinal Health (Columbus, OH)
    …payers, pharmacists and manufacturers for integrated care coordination and better patient management . Backed by nearly 100 years of experience, with more than 40,000 ... currently have a career opening for a Reimbursement Solutions Analyst. **What Clinical Operations contributes to Cardinal Health** Clinical Operations is… more
    Cardinal Health (10/15/25)
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