- Humana (Columbus, OH)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- CVS Health (Columbus, OH)
- …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and...reside in the state of Ohio + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or… more
- Evolent Health (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake … more
- Molina Healthcare (Columbus, OH)
- …LICW, LPCC or MFT. **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **KNOWLEDGE/SKILLS/ABILITIES** +… more
- Elevance Health (Columbus, OH)
- …care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational ... Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud...for multiple managed conditions to ensure cost-effective and efficient utilization of health services. Conducts assessment, planning,… more
- Highmark Health (Columbus, OH)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Elevance Health (Columbus, OH)
- …that are enabled across Carelon's Product Portfolio, inclusive of medical benefits management products, behavioral health products, payment integrity ... products, pharmacy benefit management products, specialty risk products, utilization management and prior authorizations. This Director will look across the… more
- Highmark Health (Columbus, OH)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- Highmark Health (Columbus, OH)
- **Company :** Highmark Health **Job Description :** Job Description **JOB SUMMARY** This role within the marketing & experience department will be at the forefront ... includes leveraging cutting-edge customer experience platforms, implementing robust data management solutions, and optimizing marketing automation tools to drive… more
- Highmark Health (Columbus, OH)
- …**SKILLS** + Driving technology sales + Background on IT + Background in Care Management , Utilization Management , and Digital Products and Services + ... channel growth for enGen. Work closely with marketing, sales engineering and product management to deliver on targets, objectives and provide a voice of the partner.… more
- Highmark Health (Columbus, OH)
- …resource efficiency. + Proposes ideas, designs, and solutions to lead engineers and management to further cloud service utilization and optimization. + Develops ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...of action. + Level 3 Incident, problem and change management as it pertains to the responsibilities of the… more
- Highmark Health (Columbus, OH)
- …in business terms and values. + Manage expectations of customers and management . + Represent various architectural disciplines in customer reviews and planning, ... in their areas of expertise and architecture to peers, developers, management and business users including technical expertise, coaching and ad-hoc training.… more
- Highmark Health (Columbus, OH)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** As Marketing Technology Manager, you will be the technological cornerstone of our marketing & ... utilizing these tools for a range of applications from campaign management to strategic decision-making. **ESSENTIAL RESPONSIBILITIES** + Lead the design,… more
- Humana (Columbus, OH)
- …of clinical conditions and disease states, such as oncology, falls, palliative care, behavioral health and/or other chronic conditions + Deep understanding of ... payer economics, and/or other specific healthcare areas such as EMR, Episode grouper, utilization management , value-based care, low value care etc. + Familiarity… more
- Humana (Columbus, OH)
- …of clinical conditions and disease states, such as hypertension, diabetes, kidney care, behavioral health and/or other chronic conditions + Deep understanding of ... part of our caring community and help us put health first** Humana's Clinical Analytics Team is seeking a...other specific healthcare areas such as EMR, Episode grouper, utilization management , value-based care, low value care… more
- Somatus (Columbus, OH)
- …Records) systems + Minimum three (3) years working with patients with chronic and/or behavioral health needs Ability to be credentialed in local hospital system. ... **Showing Up for You** We offer more than 25 Health , Growth, and Wealth Work Perks to help teammates...leadership and/or provider engagement to build relationships with case management teams at strategic facilities in assigned area as… more
- Battelle Memorial Institute (Columbus, OH)
- …research and development. + Provide technical briefings to team members, program management and customers as required. + Drive program and customer growth through ... (IEEE, IETF, ISO, ITU-T). + Ability to communicate technical concepts to customers, program management and teammates. + Must be sole US Citizen. + Active Top Secret… more