Top 69 Management specialist Jobs in Columbus

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
Health Information Management Specialist
Equitas Health, Inc. —Columbus, OH
- Weekends as needed
- Hybrid work
- HIPAA
- Research
- Mid-level
Quick Apply
TITLE MANAGEMENT SPECIALIST (ATE)
FRANKLIN COUNTY CLERK OF COURTS —Columbus, OH
- From $20.45 an hour
- Weekends as needed
- Word processing
- Office
- High school diploma or GED
- Commuter assistance
- Paid holidays
Senior Product Management Specialist
Branch Insurance —Columbus, OH
- $96,600 - $138,000 a year
- Full-time
- Remote
- Research
- 3 years
- Product management
- Health insurance
- Dental insurance
Specialist, Procurement and Category Management (Subcontracts)
Deloitte —Columbus, OH
- $66,200 - $121,800 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
14d
ServiceNow Queue Management Specialist
NexGen Data Systems Inc (NGDS) —Columbus, OH
- Full-time
- Remote
- Research
- Mid-level
- US work authorization
- Paid holidays
- Disability insurance
5d
Specialist, Government Client Contracts Management (Fed Health)
Deloitte —Columbus, OH
- $66,200 - $121,800 a year
- Full-time
- Mid-level
- Bachelor's degree
- Travel
Specialist, Contracts and Procurement Management
Deloitte —Columbus, OH
- $60,000 - $110,500 a year
- Full-time
- Mid-level
- Bachelor's degree
- Continuous improvement
Specialist Manager, Procurement and Category Management
Deloitte —Columbus, OH
- $93,000 - $171,300 a year
- Full-time
- Data analysis skills
- 3 years
- Bachelor's degree
Senior Product Management Specialist
Branch Financial, LLC —Columbus, OH
- $96,600 - $138,000 a year
- Full-time
- Remote
- Research
- 3 years
- Product management
- Health insurance
- Dental insurance
Quick Apply
Specialist Lead, Government Client Contracts Management (Civil)
Deloitte —Columbus, OH
- $84,300 - $155,400 a year
- Full-time
- Bachelor's degree
- Travel
- US work authorization
IT Director of Professional Services
EasyIT —Dublin, OH
- $90,000 - $120,000 a year
- Full-time
- Computer Science
- Bachelor's degree
- Mentoring
- Health insurance
- Dental insurance
Quick Apply
Order Management Specialist
Proteam Solutions Inc. —Reynoldsburg, OH
- $28 - $33 an hour
- Full-time
- Mid-level
- Office
- Analysis skills
Quick Apply
10d
Lead Physical Security Systems Specialist
Battelle —Columbus, OH
- $66,500 - $94,800 a year
- Full-time
- Hybrid work
- 6 years
- Office
- Travel
- Wellness program
- Health insurance
14d
Facilities Manager Specialist
Temco Logistics —Ohio
- $85,000 - $105,000 a year
- Weekends as needed
- Up to 50% travel
- Mid-level
- Travel
- Health insurance
- Dental insurance
Quick Apply
Specialist Lead, Procurement and Category Management (Subcontracts)
Deloitte —Columbus, OH
- $84,300 - $155,400 a year
- Full-time
- Microsoft Outlook
- Data analysis skills
- 3 years
FinCrime Ops Process Management Expert
Klarna Bank AB —Columbus, OH
- $105,394 - $118,041 a year
- Full-time
- English
- Finance
- SQL
- Health insurance
- Dental insurance
6d
The Specialist Lead, Records & Contracts
Deloitte —Columbus, OH
- $72,900 - $134,000 a year
- Full-time
- Writing skills
- Research
- 3 years
4d
Specialist Lead, Government Client Contracts Management (Fed Health)
Deloitte —Columbus, OH
- $84,300 - $155,400 a year
- Full-time
- Bachelor's degree
- Travel
- US work authorization
PRN/As Needed Behavior Management Specialist
THE VILLAGE NETWORK —Columbus, OH
- Part-time
- Computer literacy
- Mid-level
- Residential
- Paid time off
- 403(b)

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Utilization Management Specialist

ST VINCENT FAMILY SERVICES
Columbus, OH

Quick Apply

Job Details

Full-time

Benefits

Paid time off
401(k) matching

Qualifications

Associate's degree

Full Job Description

At St. Vincent Family Services, it's our job to help families build bright futures. Make it your job, too!

We offer competitive compensation based on education, experience, licensure, and internal equity, along with comprehensive benefits, 401(k) matching, and a generous PTO package.

These are just a few of the many reasons to join our team.

SUMMARY

The Utilization Management Specialist is responsible for coordinating and managing all prior authorization activities for clinical services across multiple Medicaid Managed Care Organizations (MCOs). This position serves as the primary liaison between St. Vincent Family Services and MCO payors to ensure authorization requests are submitted timely, approved services are tracked accurately, and service disruptions are prevented.

The Utilization Management Specialist monitors client eligibility, tracks authorized units by procedure code, manages authorization renewals, and communicates authorization approvals and denials to treatment teams. This role works closely with clinical staff, program leadership, billing, and MCO representatives to maximize reimbursement, ensure compliance with payer requirements, and support continuity of care for clients.

ESSENTIAL DUTIES & RESPONSIBILITIES

Maintains confidentiality and compliance with HIPAA, agency policies, and payer regulations.
Serves as the primary point of contact for all MCO prior authorization activities.
Monitors and reviews MCO portals to track authorization status, pending requests, approvals, denials, and requests for additional information.
Verifies and documents client eligibility and insurance coverage prior to authorization submission and throughout treatment episodes.
Runs authorization utilization reports and analyzes data to identify clients approaching authorization thresholds.
Maintains an authorization tracking system that includes:
- Authorization numbers
- Approved dates of service
- Procedure codes
- Authorized units
- Units utilized
- Remaining units
- Expiration dates
Monitors service utilization and proactively identify clients nearing authorized unit limits.
Requests completed clinical documentation and authorization forms from treatment providers when renewal thresholds are met.
Reviews authorization packets for completeness and accuracy prior to MCO submission.
Submits initial, concurrent, and reauthorization requests to Medicaid Managed Care Organizations within required timelines.
Coordinates responses to MCO requests for additional documentation or clinical information.
Communicates authorization approvals, denials, partial approvals, and service changes to treatment team members in a timely manner.
Collaborates with program directors, treatment providers, and billing staff to resolve authorization concerns and prevent service interruptions.
Maintains organized electronic records of all authorization submissions, determinations, and correspondence.
Tracks authorization denial patterns and communicates trends to leadership.
Assists with audits, quality assurance activities, and compliance reviews related to authorization management.
Develops and maintains productive working relationships with MCO representatives.
Participates in department meetings, training, and process improvement initiatives.
Performs other duties as assigned.

QUALIFICATIONS

Education and/or Experience:

Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
Minimum of two years of experience in healthcare authorization management, utilization management, medical billing, behavioral health administration, or related healthcare setting preferred.

Knowledge, Skills & Abilities:

Strong understanding of behavioral health authorization processes and payer requirements.
Knowledge of Medicaid and Managed Care authorization procedures preferred.
Excellent organizational skills and attention to detail.
Strong analytical skills and ability to interpret utilization and authorization reports.
Ability to manage multiple deadlines and competing priorities.
Ability to communicate effectively with clinical, administrative, and payer representatives.
Ability to maintain accurate records and follow complex payer requirements.
Ability to work independently while functioning as part of a collaborative team.

Technical Skills

Proficiency in Microsoft Outlook, Excel, Word, and Teams.
Ability to learn and navigate multiple MCO portals.
Experience with electronic health records and data management systems.
Ability to generate, analyze, and maintain utilization tracking reports.

WORK ENVIRONMENT

Standard office environment with occasional evenings/weekends for events. Hybrid schedule available after 90-day probationary period.

Requires prolonged sitting and extensive computer use.
Requires manual dexterity sufficient to operate a computer, telephone, and other office equipment.
Requires normal range of hearing and vision to prepare reports and communicate effectively.
May occasionally lift and/or move items up to 15 pounds.

Quick Apply

Refine Your Search

management specialist jobs in columbus

Utilization Management Specialist

Health Information Management Specialist

TITLE MANAGEMENT SPECIALIST (ATE)

Senior Product Management Specialist

Specialist, Procurement and Category Management (Subcontracts)

ServiceNow Queue Management Specialist

Specialist, Government Client Contracts Management (Fed Health)

Specialist, Contracts and Procurement Management

Specialist Manager, Procurement and Category Management

Senior Product Management Specialist

Specialist Lead, Government Client Contracts Management (Civil)

IT Director of Professional Services

Order Management Specialist

Lead Physical Security Systems Specialist

Facilities Manager Specialist

Specialist Lead, Procurement and Category Management (Subcontracts)

FinCrime Ops Process Management Expert

The Specialist Lead, Records & Contracts

Specialist Lead, Government Client Contracts Management (Fed Health)

PRN/As Needed Behavior Management Specialist

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