Top 94 Clinical documentation & utilization Jobs in Columbus, Oh

Appeals Nurse Consultant (Remote)
CVS Health —Columbus, OH
- $60,522 - $129,615 a year
- Weekends as needed
- Remote
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
1d
RN, LSW, LISW, Care Manager - Columbus
Careforth —Columbus, OH
- $62,657 - $84,173 a year
- Full-time
- Hybrid work
- RN License
- Experience working with individuals with disabilities
- Mid-level
- Wellness program
- Flexible schedule
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
- Weekends as needed
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid time off
- 401(k) matching
Quick Apply
2d
Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
7d
Clinical Informaticist
OhioHealth —Columbus, OH
- Full-time
- Nursing
- Microsoft Excel
- RN License
Clinical Case Manager Behavioral Health - Transition of Care - Must live in Columbus, Ohio area
CVS Health —Columbus, OH
- $60,522 - $129,615 a year
- Full-time
- Hybrid work
- LMFT
- LPC
- Psychology
- Health insurance
- Dental insurance
19h
Specialist, Utilization Review
Columbus Springs East —Columbus, OH
- Full-time
- CPR Certification
- Management
- BLS Certification
- Disability insurance
- Health insurance
Quick Apply
UR Coordinator, Full Time
RiverVista Behavioral Hospital —Columbus, OH
- $24 - $32 an hour
- Full-time
- Nursing
- Adults
- HIPAA
- Paid holidays
- Disability insurance
Quick Apply
Laboratory Research Technician - Advanced Materials
Battelle —Columbus, OH
- $50,000 - $60,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Writing skills
- Mid-level
- Wellness program
- Health insurance
Customer Success Utilization Manager
KARL STORZ —Columbus, OH
- $82,400 - $107,100 a year
- Email
- Laboratory
- Clean driving record
- Up to 50% travel
- Wellness program
- Health savings account
Outpatient Navigator
Mount Carmel Behavioral Health —Columbus, OH
- Full-time
- LMFT
- Psychiatry
- Hospital
Multi Skilled Tech - Diley Ridge -INPT rotating to ED- Night Shift Part Time 1900-0730 24hrs/wk
Mount Carmel —Canal Winchester, OH
- Part-time
- Vital signs
- Computer literacy
- BLS Certification
Epic Tapestry Certified - Utilization Management - Senior Consultant
Accenture —Columbus, OH
- $68,300 - $201,300 a year
- Full-time
- Hybrid work
- 5 years
- Office
- US work authorization
- Paid holidays
- Disability insurance
Surgical Scheduler - Plastic Surgery
Ohio State University Physicians —Columbus, OH
- $19.55 - $29.33 an hour
- Full-time
- Microsoft Access
- Surgery
- Mid-level
- Wellness program
- Paid holidays
5d
Surgical Scheduler - Eye Physicians
Ohio State University Physicians —Columbus, OH
- $19.55 - $29.33 an hour
- Full-time
- Microsoft Access
- Surgery
- Mid-level
- Wellness program
- Paid holidays
5d
Clinical Specialist - Columbus, OH
PROCEPT BioRobotics Corporation —Columbus, OH
- $108,000 a year
- Full-time
- Surgery
- Customer service
- Bachelor's degree
- Opportunities for advancement
Quick Apply
Robotics Clinical Sales Manager
Zimmer Biomet —Columbus, OH
- $115,000 - $240,000 a year
- Full-time
- Up to 50% travel
- Marketing
- Operating room
- Wellness program
OhioRISE CME Care Coordinator Supervisor I
THE VILLAGE NETWORK —Columbus, OH
- Full-time
- Experience working with individuals with developmental disabilities
- Computer literacy
- HIPAA
- Paid holidays
- Paid time off
Director of Operations Mental Health
REACH Behavioral Health —Columbus, OH
- $68,208.17 - $82,143.17 a year
- Full-time
- Nursing
- Administrative experience
- Organizational skills
Quick Apply
Clinical Nurse Informaticist
OhioHealth —Columbus, OH
- Full-time
- Nursing
- Microsoft Excel
- RN License
2d

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clinical documentation & utilization jobs near columbus, oh

Appeals Nurse Consultant (Remote)

CVS Health -
Columbus, OH

Apply Now

Job Details

Full-time
$60,522 - $129,615 a year
1 day ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

RN License
Patient care
Associate's degree

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

CVS Aetna is seeking a dedicated Appeals Nurse Consultant to join our remote team. In this role, you will play a critical role in ensuring fair and accurate resolution of clinical appeals by applying sound clinical judgment and regulatory knowledge.

Key Responsibilities

Responsible for the review and resolution of clinical appeals.
Reviews documentation and interprets data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and provider issues.
Independently coordinates the clinical resolution with internal/external clinician support as required.
This position may support UM (includes expedited), MPO, Coding, or Behavioral Health appeals.
This is a full-time telework position with standard hours of Monday–Friday, 8:00 AM to 5:00 PM (local time).
Occasional weekend and holiday on-call coverage may be required.

Remote Work Expectations

This is a 100% remote role; candidates must have a dedicated workspace free of interruptions.
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Required Qualifications

Must have active and unrestricted RN licensure in state of residence.
3+ years clinical experience.

Preferred Qualifications

Appeals, Managed Care, or Utilization Review experience.
Proficiency with computer skills including navigating multiple systems.
Exceptional communication skills.
Time efficient, highly organized, and ability to multitask.

Education

Associate's Degree minimum.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $129,615.00

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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

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.

We anticipate the application window for this opening will close on: 08/03/2026

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

clinical documentation & utilization jobs in columbus, oh

Appeals Nurse Consultant (Remote)

RN, LSW, LISW, Care Manager - Columbus

Utilization Management Specialist

Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)

Clinical Informaticist

Clinical Case Manager Behavioral Health - Transition of Care - Must live in Columbus, Ohio area

Specialist, Utilization Review

UR Coordinator, Full Time

Laboratory Research Technician - Advanced Materials

Customer Success Utilization Manager

Outpatient Navigator

Multi Skilled Tech - Diley Ridge -INPT rotating to ED- Night Shift Part Time 1900-0730 24hrs/wk

Epic Tapestry Certified - Utilization Management - Senior Consultant

Surgical Scheduler - Plastic Surgery

Surgical Scheduler - Eye Physicians

Clinical Specialist - Columbus, OH

Robotics Clinical Sales Manager

OhioRISE CME Care Coordinator Supervisor I

Director of Operations Mental Health

Clinical Nurse Informaticist

I want to receive the latest job alert for clinical documentation & utilization in columbus, oh

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