- CVS Health (Columbus, OH)
- …and implements data-driven strategies/interventions that ensure the delivery of time sensitive behavioral health benefits and services for members. The QM BH ... and supports the development of HEDIS interventions and initiatives within the Quality Management Team. The QM BH Consultant reviews documentation and… more
- CVS Health (Columbus, OH)
- …issues. * Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the ... established channels * Ability to speak to medical and behavioral health professionals to influence appropriate member...care to meet the member's goals * Utilizes case management and quality management processes… more
- Public Consulting Group (Columbus, OH)
- …a Senior Consultant in Medicaid policy and funding as it relates to children's behavioral health services and child welfare and juvenile justice services. This ... welfare, juvenile justice, early childhood, childcare, children's disability services, and children's behavioral health services. PCG is looking for a Senior… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care ... strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to...a focus on collaborative business relationships, value-based care, population health , or disease or care management *… more
- CVS Health (Columbus, OH)
- …The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral ... consults with case managers, supervisors, Medical Directors and/or other health / behavioral health programs to overcome...Monitoring, Evaluation and Documentation of Care: o Utilizes case management and quality management processes… more
- CVS Health (Columbus, OH)
- …Excellence) plan is a Medicaid managed care program that provides and coordinates behavioral health care for eligible children and youth. The Manager, Clinical ... Services strategies, policies, and programs are comprised of utilization management , quality management , network ...RN, LPPC, LPPC-S, LISW, LISW-S) **Education** Master's degree in behavioral health field; or Registered Nurse (BSN… more
- CVS Health (Columbus, OH)
- …/ Managed care experience preferred. **Education** + LPN or bachelor's degree in behavioral health or health care related field (psychology, social ... and promote lifestyle/behavior changes to achieve optimum level of health . * Documentation of Care: Utilizes case management...**Dearborn County** + 2 years' LPN experience or in behavioral or physical health , social services, or… more
- Highmark Health (Columbus, OH)
- **Company :** Allegheny Health Network **Job Description :** The Quality and Patient Safety Administrative Intern will be working alongside the Quality ... + Perform miscellaneous job-related duties as assigned. + Project Management for Quality /Patient Safety initiatives. + Preparation...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- CVS Health (Columbus, OH)
- …with the Behavioral Health , Pharmacy, member outreach, Care Management , National Quality Management , Utilization Management , Compliance, ... health populations to optimize risk adjustment, clinical quality , and care management . * Actively participate...departments to integrate social, behavioral , and physical health and improve clinical program execution. * In collaboration… more
- CVS Health (Columbus, OH)
- …including after-hours consultation as needed. * Leading all major clinical, population health management , and quality improvement components of the ... Management committee and of the OhioRISE Plan's internal quality improvement committee. * Play a lead role in...* At least five years of experience with children's behavioral health services. * Must be a… more
- Highmark Health (Columbus, OH)
- …range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics ... over specified panel of members by performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address… more
- AmeriHealth Caritas (Dublin, OH)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... **Utilization Management Plan Oversight Manager (Ohio Resident)** Location: Dublin,...now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate… more
- Humana (Columbus, OH)
- …Improvement, Utilization Management , Population Health , Social Determinants of Health , Pharmacy, Behavioral Health , Long-Term Services and Supports, ... information. **Preferred Qualifications** + MBA programs with a specialization in Healthcare Management **OR** Master's Degree in Public Health programs. +… more
- Humana (Columbus, OH)
- …Utilization Management , Population Health , Social Determinants of Health , Pharmacy, Behavioral Health , Institutional Long-Term Services and ... Managed Care Organization (MCO) focusing on Medicaid clinical strategy and population health management strategy. **Alternatively** **,** 5+ years of experience… more
- Humana (Columbus, OH)
- … health care space, such as utilization management , pharmacy, care management , behavioral health . + Proficiency in Microsoft Office programs. + ... part of our caring community and help us put health first** Humana Healthy Horizons is seeking an Associate...is seeking an Associate Director, Medicaid Implementation (Business Project Management ) to lead within a specific defined business area… more
- AmeriHealth Caritas (Dublin, OH)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... agencies. **Other Skills:** + Health care industry and/or Medicare/Medicaid/Pharmacy/ Behavioral Health /Pharmacy Benefit Management knowledge required. +… more
- CVS Health (Columbus, OH)
- …The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral ... Bring your heart to CVS Health . Every one of us at CVS ...screening and referrals to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services. Additional responsibilities to include… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** AVP, Product Management sets product vision develops, delivers, and manages product ... adoption for achieving positive business outcome. The AVP, Product Management requires an in-depth understanding of how organization capabilities interrelate… more
- Highmark Health (Columbus, OH)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job supports one or more analytical aspects of the product management lifecycle, within ... to verify and govern delivery of customer needs, and ensure on-time, quality delivery. The incumbent identifies, documents, and resolves moderate to complex risks,… more
- Highmark Health (Columbus, OH)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This role will have dual responsibilities supporting Epic Clarity report writing and supporting ... one or more analytical aspects of the product management lifecycle. Supporting report writing will include working with Business Intelligence and healthcare… more