Top 182 Claim manager Jobs in Columbus, Oh

Case Manager, Registered Nurse (Oncology experience required)
CVS Health —Columbus, OH
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- RN License
- Health insurance
- Dental insurance
Construction Manager
Ascension Construction Solutions —Columbus, OH
- $100,000 - $150,000 a year
- Full-time
- Microsoft Word
- Background check
- Management
- Health savings account
- Health insurance
Quick Apply
Branch Manager
Lifetime Quality Roofing —Columbus, OH
- Full-time
- Mid-level
- 3 years
- Recruiting
- Fuel card
- Health insurance
Quick Apply
Primary Pack Operations Manager 2nd Shift
ID Logistics —West Jefferson, OH
- $82,000 - $110,000 a year
- Monday to Friday
- Ability to walk for extended periods
- 5 years
- Mid-level
- Health insurance
- Dental insurance
Medical Billing and Appeals Team Lead - Prosthetics
Optimus Prosthetics —Columbus, OH
- Full-time
- Mid-level
- Office
- In-person
- Health savings account
- Health insurance
Quick Apply
3d
Account Manager I
Delta Dental of Michigan —Dublin, OH
- Full-time
- Hybrid work
- Mid-level
- Analysis skills
- Bachelor's degree
- Dental insurance
- Opportunities for advancement
Manager, Business Office
SUN Behavioral Columbus —Columbus, OH
- Full-time
- 5 years
- Writing skills
- Mid-level
Human Resources Manager
Vaco by Highspring —Delaware, OH
- $110,000 - $120,000 a year
- Spanish
- 7 years
- Supervising experience
- Health insurance
- Dental insurance
Quick Apply
5d
Data Center Repair Lead
EOS —New Albany, OH
- $80,000 - $95,000 a year
- Rotating shift
- 5 years
- Driver's License
- Continuous improvement
- Paid holidays
- Health insurance
Quick Apply
Senior Project Manager - Columbus Market - Data Center Construction
Michael Page —Columbus, OH
- $150,000 - $180,000 a year
- Hybrid work
- Construction site
- Bachelor's degree
- Experience equivalent to degree accepted
- Health insurance
- 401(k)
Assistant Branch Manager - Sales Manager Trainee
Republic Finance, LLC —Groveport, OH
- $45,000 a year
- Full-time
- Pass drug screening
- Office
- Windows
- Paid training
- Paid holidays
Inbound and Inventory Control Manager
Metro Supply Chain Holdings USA Inc —Columbus, OH
- $80,000 - $85,000 a year
- Full-time
- Background check
- Microsoft Excel
- Pass drug screening
- Disability insurance
- Health insurance
Quick Apply
Homecare - Revenue Cycle Manager – Remote
PurposeCare —Columbus, OH
- $80,000 - $95,000 a year
- On call
- Travel
- Home Health
- Organizational skills
Quick Apply
Billing & Collections Manager (BOM)
Taylor Springs Health Campus —Gahanna, OH
- From $30 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Long term care
- Paid parental leave
- Health savings account
Billing & Collections Manager (BOM)
Violet Springs Health Campus —Pickerington, OH
- From $30 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Long term care
- Paid parental leave
- Health savings account
Travel Manager
Anduril Industries —Ashville, OH
- $87,000 - $116,000 a year
- Email
- Mid-level
- Office
- Microsoft Office
Quick Apply
OhioRISE CME Care Coordinator Supervisor II
THE VILLAGE NETWORK —Columbus, OH
- $68,000 - $77,000 a year
- Full-time
- Computer literacy
- Mid-level
- Office
- Paid holidays
- Paid time off
Client Service Supervisor
Gallagher —Upper Arlington, OH
- $73,500 - $123,000 a year
- Full-time
- Hybrid work
- High school diploma or GED
- Supervising experience
- Bachelor's degree
- Paid parental leave
- Health savings account
Field Support Supervisor, Customer Success
Sidecar Health —Columbus, OH
- Remote
- Mid-level
- Travel
- Reliable transportation
- Paid holidays
- Health insurance
Operations Manager
Sedgwick —Dublin, OH
- Hybrid work
- Computer literacy
- Writing skills
- Office

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claim manager jobs near columbus, oh

Case Manager, Registered Nurse (Oncology experience required)

CVS Health -
Columbus, OH

Apply Now

Job Details

Full-time
$54,095 - $155,538 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

RN License
Medical records
Typing
Oncology
Hospital experience

Full Job Description

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 everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

This is a remote work from home role anywhere in the US with virtual training.

American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.

Key Responsibilities

This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients.
Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits.
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
Assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives.
Utilizes case management processes in compliance with regulatory and company policies and procedures.
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversations.
Identifies and escalates member’s needs appropriately following set guidelines and protocols.
Need to actively reach out to members to collaborate/guide their care.
Perform medical necessity reviews.

Required Qualifications

5+ years’ experience as a Registered Nurse, including at least 1 year in a hospital setting.
The AHH RN Case manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support
1+ years’ experience documenting electronically using a keyboard.
1+ years’ current or previous experience in Oncology.

Preferred Qualifications

1+ years’ Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience as well as experience with transferring patients to lower levels of care.
1+ years' experience in Utilization Review.
CCM and/or other URAC recognized accreditation preferred.
1+ years’ experience with MCG, NCCN and/or Lexicomp.
Bilingual in Spanish preferred.
Bachelors Degree

Education

Diploma or Associates Degree in Nursing required.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $155,538.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

claim manager jobs in columbus, oh

Case Manager, Registered Nurse (Oncology experience required)

Construction Manager

Branch Manager

Primary Pack Operations Manager 2nd Shift

Medical Billing and Appeals Team Lead - Prosthetics

Account Manager I

Manager, Business Office

Human Resources Manager

Data Center Repair Lead

Senior Project Manager - Columbus Market - Data Center Construction

Assistant Branch Manager - Sales Manager Trainee

Inbound and Inventory Control Manager

Homecare - Revenue Cycle Manager – Remote

Billing & Collections Manager (BOM)

Billing & Collections Manager (BOM)

Travel Manager

OhioRISE CME Care Coordinator Supervisor II

Client Service Supervisor

Field Support Supervisor, Customer Success

Operations Manager

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