- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. **Position Summary** The Care Plan Reviewer ( Clinical Case Manager BH) utilizes ... Independent BH Clinical License: LPCC, IMFT, or LISW + Managed care /utilization review experience + Case management and discharge planning experience… more
- US Tech Solutions (Columbus, OH)
- …**Duration: 03 months(Possible FTE)** **Tentative Start Date-:** **12/22/2024** **Responsibility:** + The Care Plan Reviewer ( Clinical Case Manager ... child-serving systems. + Assessment of Members: + Through the use of clinical tools and information/data review , conducts comprehensive assessments of referred… more
- CVS Health (Columbus, OH)
- …insured individuals, providers, claimants, etc. + Analyze and prepare cases for clinical and legal review , ensuring all documentation meets required standards. ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...of three years of Medicaid Fraud, Waste, and Abuse review experience. + Billing and Coding certifications such as… more
- Sharecare (Columbus, OH)
- …and needs for participant education. + Develops and facilitates implementation of a care plan addressing the total healthcare needs of the participants. Specific ... orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required...who ** ** recognizes the impact of the health care delivery system on the clinical and… more
- Evolent (Columbus, OH)
- …Participates in the development and implementation of new strategies to make the clinical review process more efficient through people, processes, and technology ... primary care , we seek to ensure that care plans align with clinical evidence, respect... operation initiatives within a progressive and forward-thinking health care organization. + Experience in health plan … more
- Guardian Life (Columbus, OH)
- …issues, work capacity and RTW opportunities. Conduct analysis of claimant's current treatment plan and collaborate with health care providers and claimants to ... **Position Summary** The RN Clinical Consultant serves as a clinical ...with treating providers to assist individuals to obtain appropriate care and ensure optimal treatment outcomes and acts with… more
- Abbott (Columbus, OH)
- …114,000 colleagues serve people in more than 160 countries. **Senior Clinical Research Specialist** **Working at Abbott** Our nutrition business develops ... you can do work that matters, grow, and learn, care for yourself and your family, be your true...qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the… more
- Prime Therapeutics (Columbus, OH)
- …and improve care . Serves as facilitator and mentor to the clinical liaisons for assigned contract(s). Assists Account Managers with managing overall client ... recommendations is essential for both the client's cost of care and the overall administration of the programs. Activities...years of experience in Pharmacy Benefits Management (PBM), Health plan or Medicaid clinical customer service. +… more
- Prime Therapeutics (Columbus, OH)
- …and other research applications and opportunities beneficial or of interest to the plan + Provide clinical guidance and support for client's Health Insurance ... business + Manage incoming requests for information from the plan regarding drug therapy, formulary and clinical ...years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at… more
- Takeda Pharmaceuticals (Columbus, OH)
- …patients worldwide. Join Takeda as an Associate Director, Global Patient Safety Clinical Operations in Cambridge, MA, where you will provide functional expertise and ... and accountability of PV Activities globally, including set up and conduct of clinical studies from a PV perspective. You will partner with key stakeholders within… more
- Molina Healthcare (Columbus, OH)
- …(HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the ... continuum, including behavioral health and long-term care , for members with high need potential. HCS staff...all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence… more
- Elevance Health (Columbus, OH)
- …for autism and depression, and insightful analytics to improve the delivery of care . The ** Clinical Ops Associate Medical Director - Ortho** is responsible ... make an impact:** + Determines the medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization… more
- Molina Healthcare (Columbus, OH)
- …(HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the ... health plan supervisory or managerial experience, including oversight of clinical staff. + Experience working within applicable state, federal, and third party… more
- Fujifilm (Columbus, OH)
- …via phone at ###, or via e-mail at ###@fujifilm.com . Additionally, the affirmative program/ plan is available for review upon formal request by employees and ... **Overview** ** Clinical Specialist (ARDMS Certification Required) - Milwaukee, WI**...at FUJIFILM Sonosite. As the creator of point of care ultrasound, we dedicate every day to the innovation… more
- Baylor Scott & White Health (Columbus, OH)
- **JOB SUMMARY** Clinical Doc Improvement Specialist 1 performs patient record reviews concurrently and/or retrospectively to determine complete, accurate and timely ... to physicians when needed to clarify ambiguous or incomplete documentation. The Clinical Doc Improv Spec 1 should have knowledge of ICD-10, Complications/Comorbid… more
- Prime Therapeutics (Columbus, OH)
- …drives every decision we make. **Job Posting Title** Dir, Specialty Clinical Solutions/Medical pharmacy exp required- REMOTE **Job Description** + Supports overall ... identification opportunities for improved management of Medical benefit drugs through clinical research and analytics that improve medical cost savings and provide… more
- CenterWell (Columbus, OH)
- …patients to offer medication therapy management programs and schedules medication review sessions with consultative pharmacists. Decisions are typically focus on ... benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan , time off (including paid time off, company and personal holidays,… more
- CVS Health (Columbus, OH)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. The Special Investigations Unit is seeking… more
- Cardinal Health (Columbus, OH)
- …+ 4-8 years of experience, preferred + Minimum of five (5) years of clinical nursing involving direct patient care , preferably in Medical/Surgical, Intensive ... Burn Unit + Knowledge of quality improvement and patient safety across the care continuum. + Experience in quality improvement, clinical risk management,… more
- Option Care Health (Columbus, OH)
- …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining ... margin of assigned therapies. Creates a VA specific sales plan and regularly assesses progress on opportunities within assigned...alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able… more