84 utilization opportunities in Columbus updated today
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· Page 1 / 5Who we are Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for
Behavioral Health Utilization Management Medical Case Manager CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready
CenterWellBecome a part of our caring community Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team th
PwCSpecialty/Competency: Operations Industry/Sector: Health Services Time Type: Full time Travel Requirements: Up to 80% At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs
HumanaBecome a part of our caring community The Utilization Management Behavioral Health Professional uses behavioral health knowledge to support the coordination, documentation, and communication of medical services and benefit administration determinations. Reporting to the UMB Manager, the UMB Health P
CVS HealthWe’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e
Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide judgment to review medical services with evidence‑based criteria, authorize requested s
A leading healthcare company is seeking a Registered Nurse for a Utilization Management role in Columbus, Ohio. This position involves assessing and coordinating healthcare services while ensuring effective communication with providers. Preferred candidates should have at least 2 years of experience
A leading healthcare company is seeking a Behavioral Health UM Clinician in Columbus, Ohio. The role involves reviewing behavioral health services, coordinating care, and ensuring appropriate treatment plans for members. Candidates must have a master's-level Behavioral Health license or be a registe
A leading health solutions company seeks a Utilization Management RN to evaluate efficiency and medical necessity for services. The role requires nursing experience and collaboration with medical directors while offering remote and hybrid work options. Candidates should have strong analytical and co
A healthcare company is seeking a Medical Management Nurse to handle complex cases requiring in-depth analysis and nursing judgment. This role offers flexible virtual work with occasional in-person training. Candidates should have an associate’s degree in nursing, an active RN license in California,
Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services-creating tangible value at speed and scale. We are a
A healthcare staffing company seeks Remote Clinical Review Nurses to review around 20 cases daily for medical necessity. Responsibilities include advocating for members to avoid unnecessary hospital admissions and completing authorizations according to procedures. Candidates should have at least 3 y
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e
PWCIndustry/Sector Health Services Specialism Operations Management Level Manager Job Description & Summary As an operations consulting generalist at PwC, you will possess a broad understanding of various aspects of operations consulting. You will provide comprehensive guidance and support to clien
Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration determinations. You will report to the Manager of Utilization Manag
HumanaA leading US healthcare company is seeking a Utilization Management Administration Coordinator to provide non-clinical support for members. This fully remote position involves managing chart reviews, authorizations, and engaging with providers. Candidates should have over a year of administrative ex
KnowHireMatchTITLE: Director Case Management / Utilization Management / CDI Location: Buckeye Lake, OH Now is your chance to join a Forbes magazine top 100 hospital where career growth and opportunity await you. They are committed to building healthcare teams whose care exceeds the expectations of their patients
The Ohio State UniversityA prestigious educational institution is seeking a Utilization Care Manager - RN to contribute to their Utilization Management Program. This remote role requires a bachelor's degree in Nursing and RN licensure, along with two years of experience in Care or Utilization Management. The UCM will determ
The Ohio State University Wexner Medical Center*Scope/Position Summary** The Utilization Care Manager (UCM) contributes to the hospital's Utilization Management Program Plan by using medical necessity guidelines to determine appropriateness for inpatient level of care or observation services based on documented clinical information in compliance
*Job Address:** 10270 Blacklick - Eastern Road NW Pickerington, OH 43147 *New Vista Health and Wellness** is currently recruiting a **Utilization Review Coordinator** for our team in Columbus OH! *WHO WE ARE** *The New Vista mission:** ***Inspiring Hope, Restoring Peace of Mind, Healing Lives.*** At
We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn
A leading healthcare provider in Ohio is seeking a Director of Case Management. This full-time position involves overseeing inpatient and ED case management while ensuring compliance and quality patient care. Applicants should have a Master's degree and current RN licensure, along with leadership an
Quantum HealthLocation This position is located at our Dublin, OH campus with hybrid flexibility Who we are Founded in 1999 and headquartered in Central Ohio, w e’re a privately-owned , independent healthcare navigation organization . We believe that no one should have to navigate the cost and complexity of healt
Contract LumberA leading logistics company in Pataskala, Ohio is seeking a Fleet Analyst to enhance fleet performance through data analysis. This role involves building and utilizing reports to improve fleet management efficiency for about 1,200 assets. Ideal candidates should have a Bachelor's degree and 3+ years
*Who we are** Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective f
A leading logistics company in Pataskala, Ohio is seeking a Fleet Analyst to enhance fleet performance through data analysis. This role involves building and utilizing reports to improve fleet management efficiency for about 1,200 assets. Ideal candidates should have a Bachelor's degree and 3+ years
Director Case Management / Utilization Management / CDI Location: Buckeye Lake, OH Base Pay Range $130,000.00/yr - $156,000.00/yr Now is your chance to join a Forbes magazine top 100 hospital where career growth and opportunity await you. The hospital is committed to building healthcare teams whose
$40,000 – $63,000/year
Estimation confidence: Low
Estimate based on market data for Columbus. Actual salaries may vary depending on experience, company, and area.
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