• Complex Case Manager RN

    Highmark Health (Columbus, OH)
    **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote ** This job has primary ownership and oversight over a specified panel of members ... interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
    Highmark Health (11/20/24)
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  • Registered Nurse - MICU Nurse

    Veterans Affairs, Veterans Health Administration (Cleveland, OH)
    Summary The Northeast Ohio VA Healthcare System is recruiting for one full-time Registered Nurse - Nurse Manager . The Registered Nurse - Nurse ... level degree in Nursing may have opportunity to become registered as a nurse with a state...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
    Veterans Affairs, Veterans Health Administration (12/21/24)
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  • Behavioral Health Case Manager - SUD

    Molina Healthcare (Cincinnati, OH)
    …looking for a Licensed Social Worker to do telephonic Behavioral Health Case Manager . This role will work in remote setting supporting our Medicaid SMI ... assistance to member to address concerns. * Collaborates with RN case managers/supervisors as needed or required...the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's… more
    Molina Healthcare (01/08/25)
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  • Lead, Auditor ( RN ) Appeals & Grievances…

    Molina Healthcare (Columbus, OH)
    …to resolve/correct them.. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or ... be discussed during our interview process. This is a remote position. Work hours: Monday- Friday: 8:00am -5:00pm. Michigan...+ Required License, Certification, Association + Active, unrestricted State Registered Nurse ( RN ) License in… more
    Molina Healthcare (01/13/25)
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  • Care Manager RN - Weekends…

    Highmark Health (Columbus, OH)
    …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
    Highmark Health (01/07/25)
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  • Field Care Manager , Behavioral Health…

    Humana (Parma, OH)
    …Clinical Social Worker (CSW), Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), or Registered Nurse ( RN ). + Minimum of 2 years of ... caring community and help us put health first** Combination remote work at home and onsite member facing. Must...and Committed? If so, apply today! The Field Care Manager , Behavioral Health 2 work assignments are varied and… more
    Humana (11/19/24)
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  • RN Home Health - Various Shifts & Locations

    Cleveland Clinic (Cleveland, OH)
    …are available for all areas. + RN Homecare Case Manager - 5-8s + RN Homecare Visit Nurse (Non- Case Manager ) - 5-8s & 4-10s + PRN (required to ... equipment as required. Keywords: Homecare, Flexible, Autonomous, Home, Registered Nurse , PRN, remote , Travel RN Salaries [which may be] shown on… more
    Cleveland Clinic (01/04/25)
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  • PAR - Case Manager II

    Medical Mutual of Ohio (Toledo, OH)
    **_The Case Manager II position allows you the...preferred. . 3 years as a Registered Nurse with a combination of clinical and case ... health care experience is a plus. **Professional Certification(s):** . Registered Nurse with current State of Ohio...state licensure preferred and may be required. . Certified Case Manager (CCM) or other industry recognized… more
    Medical Mutual of Ohio (01/09/25)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Columbus, OH)
    …+ Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of ... **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote - Part Time - Weekends Required.** This job implements the effective utilization… more
    Highmark Health (12/12/24)
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  • Care Manager - Remote

    Sharecare (Columbus, OH)
    …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... **Job Description:** **Job Summary:** The Care Manager supports the implementation of the Value Based...an appropriate and efficient manner by providing high-quality telephonic Case or Care Management with CareFirst members. The Care… more
    Sharecare (12/04/24)
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  • Field Care Manager , Behavioral Health

    Humana (Columbus, OH)
    …of post-degree clinical experience in behavioral health **OR** an active, unrestricted Kentucky Registered Nurse **( RN )** license with at least three years ... Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate...to troubleshoot and resolve basic technical difficulties in a remote environment. + This role is considered patient facing… more
    Humana (11/20/24)
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  • Senior Manager , PV Operations

    Takeda Pharmaceuticals (Columbus, OH)
    …of contact for vendor operations and vendor oversight, including vendors performing case management, case intake (ie, Call Centers), scientific literature ... contact for vendor operations including the PV BPO vendor and/or vendors performing case management, case intake, literature review; call centers + Provide… more
    Takeda Pharmaceuticals (01/10/25)
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  • Risk Adjustment Provider Programs Specialist

    Medical Mutual of Ohio (OH)
    …+ **Medical /clinical background highly desirable.** **Professional Certification(s)** + ** Registered Nurse preferred** + **Certified Professional Coder (CPC) ... and assist in the review of provider agreements.** + **Acts as project manager over large internal risk adjustment projects (eg, Optum In Office Assessment program… more
    Medical Mutual of Ohio (12/06/24)
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