• Complex Case Manager

    Highmark Health (Columbus, OH)
    …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
    Highmark Health (03/13/25)
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  • Care Manager II - Bright Start Maternity

    AmeriHealth Caritas (Columbus, OH)
    …meeting goals and resolving problems. Coordinates care and services with the Account manager , Complex RN Case Manager , and member, family members as ... us at; www.amerihealthcaritas.com .; **Responsibilities:** The Bright Start Care Manager RN assists members appropriate for care...candidates must reside in Ohio. . Current and unrestricted Registered Nurse licensure in Ohio. . Nursing… more
    AmeriHealth Caritas (03/04/25)
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  • Manager , Utilization Management…

    Humana (Columbus, OH)
    …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in Virginia or enhanced compact license, ... part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support the coordination,… more
    Humana (03/12/25)
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  • Care Manager , Registered

    Sharecare (Columbus, OH)
    …of their members to ensure successful completion of member goals, while providing Complex Case Management and/or care management support through the duration of ... within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required,… more
    Sharecare (02/17/25)
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  • Case Manager , RN

    CAI (Columbus, OH)
    …Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next level! ... apply now. **Job Description** We are looking for a Case Manager , RN to provide...duties as assigned/requested **What You'll Need** Required: + Current Registered Nurse , licensed in the state of… more
    CAI (02/01/25)
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  • Case Manager ( RN ) Ohio,…

    Molina Healthcare (Delaware, OH)
    REGISTERED NURSE , must reside and be willing to travel in FRANKLIN COUNTY OHIO area, including but not limited to: Franklin, Delaware, Pickaway, Madison, and ... travel required. + RNs provide consultation, recommendations and education as appropriate to non- RN case managers. + RNs are assigned cases with members who… more
    Molina Healthcare (02/11/25)
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  • Case Manager RN - Field…

    CVS Health (Delaware, OH)
    …schedule, paid holidays, and flexibility as you coordinate the care of your members. Nurse Case Manager is responsible for telephonically and/or face to ... counties). We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Registered Nurses to join our Case Management team. This… more
    CVS Health (02/12/25)
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  • Behavior Health Case Manager I (US)

    Elevance Health (Columbus, OH)
    Behavior Case Manager I **Location:** Ohio This is a remote position. The ideal candidate will live within 50 miles of one of our Ohio PulsePoint locations. The ... Behavior Health Case Manager...social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder… more
    Elevance Health (03/13/25)
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  • Telephonic Nurse Case Manager

    Elevance Health (Columbus, OH)
    **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is...management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing,… more
    Elevance Health (03/18/25)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Columbus, OH)
    …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (01/25/25)
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  • Nurse Case Mgr II

    Elevance Health (Columbus, OH)
    ** Nurse Case Manager II** **Office Location:** Atlanta/Columbus, GA; Indianapolis, IN; Cincinnati/Columbus/ Mason, Seven Hills, OH; Houston/Grand Prairie, ... shift differential of 10% for evening shift_ .** The ** Nurse Case Manager II** is...management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing,… more
    Elevance Health (03/07/25)
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  • Manager , Utilization Management Behavioral…

    Humana (Columbus, OH)
    …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... coaching, performance review, up to termination. + Certified or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work… more
    Humana (03/12/25)
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  • Trainer - Clinical Services - Utilization Review…

    Molina Healthcare (Columbus, OH)
    …knowledge on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or Bachelor's ... or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified… more
    Molina Healthcare (03/13/25)
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