1w
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UTILIZATION SPECIALIST-E.D.
Middleburg Heights, Ohio, United States
OnsiteFull Time
5+ YOEBSN preferred; current Ohio RN license required; minimum 5 years clinical nursing experience; utilization/case management experience and Interqual/MCG screening criteria preferred; strong critical thinking, communication, and computer skills.
Interqual, MCG
18h
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Utilization Management Specialist
Columbus, Ohio, United States
HybridFull Time
2+ YOE2+ years healthcare authorization or utilization management experience preferred; Associate's degree required (Bachelor's preferred); proficiency with MCO portals, EHRs, Microsoft Office; strong analytical and communication skills.
Microsoft Outlook, Microsoft Excel, Microsoft Word, Microsoft Teams, Electronic Health Records
1mo
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Specialist, Utilization Review
Columbus, Ohio, United States
OnsiteFull Time
Bachelor's degree required (Master's preferred). Utilization review experience in psychiatric healthcare preferred. Strong clinical knowledge, ability to interface with payers, CPR and CPI preferred, clinical license strongly preferred.
1mo
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Resource Utilization Coor
Toledo, Ohio, United States
$33-$43/hr OnsiteFull Time
3+ YOEActive Ohio RN license and BLS required; BSN required (MSN acceptable) or 5 years relevant experience; minimum 3 years acute/behavioral clinical nursing; proficient with Word/Excel/Internet/e-mail; able to lift 50 lbs and work flexible/rotating hours including weekends/holidays; case management/utilization review experience preferred.
Microsoft Word, Microsoft Excel, Internet, e-mail
6d
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Utilization Review Specialist - Autism
Columbus, Ohio, United States
HybridFull Time
3+ YOEBachelor's in social work/psychology required; 3 years behavioral health experience and 1 year pediatric experience; utilization review experience preferred; knowledge of CMS standards; strong communication and organizational skills.
CM, MITS, payer web applications
2w
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RN Utilization Rvw Spclst - Utilization Management
Miamisburg, Ohio, United States
OnsitePart Time
5+ YOEActive Ohio RN with BSN, 5 years clinical experience (including 2 years case management), case management certification, experience with EPIC and Microsoft applications, knowledge of MCG Care guidelines, and clinical review/appeals experience.
EPIC, MCG Care, Microsoft applications
2w
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RN Utilization Rvw Spclst - Utilization Management
Miamisburg, Ohio, United States
OnsitePart Time
5+ YOEActive Ohio RN with BSN, 5 years clinical experience (2 years case management), case management certification preferred, familiarity with MCG care guidelines, EPIC and Microsoft applications experience, strong communication and independent workflow skills.
EPIC, MCG Care, Microsoft applications
3w
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Director, Utilization Management & Operational Integrity
Brooklyn, Ohio, United States
HybridFull Time
8+ YOE5+ MgmtBSN required (MS preferred), RN with current unrestricted license, ability to obtain Ohio or multi-state RN within hire windows, 8+ years utilization management experience with 5+ years leadership, knowledge of NCQA/CMS/HIPAA, Microsoft Office proficiency.
Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, EMRs/Portals
4w
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Regional Manager Utilization Management
Cleveland or Indian River County or Martin County or Weston or Florida
RemoteFull Time
3+ YOE1+ MgmtBachelor's degree and RN program completion, Florida RN license, BLS required, 3 years clinical nursing, 2 years utilization review/care management, 1 year healthcare management, proficiency with Microsoft Office and clinical/financial systems, data analysis and UR knowledge.
Microsoft Office
4w
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Utilization Review Specialist
Portage Lakes, Ohio, United States
$40k/yr OnsiteFull Time
1+ YOEBachelor's degree required, 1 year human services experience, Excel skills and ability to learn Ohio billing software, experience with documentation review, record organization, and occasional travel; may supervise clerical staff.
Microsoft Excel
2mo
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Utilization Review Specialist
University Heights, Ohio, United States
$60k/yr OnsiteFull Time
1+ YOE1-2 years related experience; associates degree in Nursing, Social Work, or Behavioral Sciences; licensure in LPN, RN, LSW, LPC, MFT, LISW, LPCC or LMFT; strong communication and clinical knowledge.
3w
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Director, Utilization Management & Operational Integrity
Brooklyn, Ohio, United States
HybridFull Time
8+ YOE5+ MgmtBScN required (Master's preferred). Requires RN license, 8+ years progressive utilization management experience with 5+ years in leadership, NCQA/CMS/HIPAA knowledge, Microsoft Office proficiency, and strong communication and process-improvement skills.
NCQA, CMS, HIPAA, EMR, Microsoft Office, Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, ICD-10, CPT, HCPCS
1mo
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Utilization Management (UM) Coordinator
Blue Ash, Ohio, United States
$27-$34/hr OnsiteFull Time
CommuniCare Health Services: Operates skilled nursing and behavioral health care facilities.
Performs precertification/recertification, concurrent reviews, peer-to-peer reviews and appeals; ensures discharge planning and documents authorizations/denials; knowledge of Medicare/Medicaid/managed care and relevant laws; CPR and Handle with Care training required.
3w
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Customer Success Utilization Manager
United States or Columbus
$82k-$107k/yr FieldFull Time
2+ YOE2+ years relevant OR sales/service or technical experience (2–3 years preferred), Bachelor's degree preferred or equivalent experience, willingness to travel 50–80%+, strong communication and project management, hospital credentialing and good driving record.
Salesforce, OR1
1w
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Utilization Management Behavioral Health Professional
Kentucky or Ohio or West Virginia or Virginia or Indiana or Illinois or Tennessee or Missouri
$65k-$89k/yr RemoteFull Time
3+ YOEMust reside in KY or contiguous counties, Bachelor's in nursing or Master's in Human Services plus professional license, 3+ years clinical experience, intermediate Microsoft Office skills.
Microsoft Teams, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Microsoft Word
1mo
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Locate Technician (Entry Level) - Columbus, OH & The Greater Surrounding Areas
Groveport or Columbus
$20/hr FieldFull Time
Entry-level utility locator; high school diploma or equivalent, valid driver license, pass background and drug screen, able to walk miles, lift up to 25 lbs (with aids for heavier lifts).
laptop computer
1mo
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Epic Tapestry Certified - Utilization Management - Senior Consultant
Nashville or Dallas or Columbus or Atlanta
$63k-$219k/yr HybridFull Time
5+ YOE5+ years in Healthcare IT in an Epic non-clinical leader role, Epic Tapestry certification and certification in an Epic non-clinical app, bachelor's degree or equivalent, project planning, stakeholder communication, and system configuration/testing experience.
Epic Tapestry, Microsoft Excel, Gen AI
2w
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Journeyman Lineworker / Apprentice Lineworker
New Concord, Ohio, United States
OnsiteFull Time
High school diploma or equivalent, ability to climb poles, valid Ohio CDL Class A, willing to work overtime and call-out duties, reside within 30-minute response to New Concord office.
3d
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Maintenance Tech 2/Tech 3
Delaware, Ohio, United States
$28-$37/hr OnsiteFull Time
5+ YOEApprenticeship/military or related training plus 5+ years (Tech2) or 7+ years (Tech3) electrical/maintenance experience; electromechanical aptitude, experience with high voltage AC, PLCs, MCCs, instrumentation, basic computer/Microsoft Office, valid driver\u0002s license, high school diploma/GED.
PLC, MCC, Microsoft Office
1w
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Wastewater Plant Operator
Akron, Ohio, United States
$52k-$63k/yr OnsiteFull Time
1+ YOEOperate and maintain wastewater treatment plant equipment, perform process control tests, take samples, perform minor repairs, keep operational records, and work rotating shifts including weekends and holidays.
SCADA
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