- Humana (Columbus, OH)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Elevance Health (Columbus, OH)
- ** Director I Medicare Operations** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one ... Medicare and Medicaid Services to transform federal health programs. The ** Director I Medicare Operations** is responsible for directing multiple business… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Columbus, OH)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Double Board ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Columbus, OH)
- …and behavioral health programs and services to its membership. Aetna is looking for a medical director to be part of a centralized team that supports the ... related to precertification, concurrent review, and appeal request. The medical director is a work-at-home position located...Two (2) + years of experience in managed care ( Medicare and/or Medicaid) Experience with managed care ( Medicare… more
- CVS Health (Columbus, OH)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... in both our Dually Eligible Special Needs Plan (DSNP) and our Medicare -Medicaid Plan (MMP) programs. We collaborate with members, providers, and community… more
- CVS Health (Columbus, OH)
- …clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to ... and services for aligned plan's members. Position Description: Aetna Medicare Duals Center of Excellence is searching for a...the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
- Elevance Health (Columbus, OH)
- ** Director of Contracts & Procurement** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... our Elevance Health PulsePoint locations. ** National Government Services** is a proud member of Elevance...Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Director , Talent Management develops, implements, and evaluates employee development plans and programs ... succession planning, technical or nontechnical training, or e-learning. The Director , Talent Management requires an in-depth understanding of how organization… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Associate Director , Agile Coaching guides, educates, and mentors organizational leaders and their teams to ... including Scrum, Kanban and Scaled Agile Framework (SAFe). The Associate Director , Agile Coaching requires a solid understanding of how organization capabilities… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Director , Broker Digital Sales (Innovation Portfolio Strategy) utilizes ideas, identifies innovation ... opportunities, and translates ideas into actionable and profitable business. The Director , Innovation Portfolio Strategy requires an in-depth understanding of how… more
- Ciena Healthcare (Columbus, OH)
- …a growing organization? The Laurels of West Columbus has an exceptional opportunity for a Director of Nursing (DON) to join our team. We are a small, close knit ... long term dedicated associates, and great census! As the Director of Nursing (DON), you will plan, coordinate and...Nursing Assistants (STNA). **Benefits:** + Comprehensive health insurance - medical , dental and vision. + 401K with matching funds.… more
- Ciena Healthcare (Mount Vernon, OH)
- …opportunity with a growing organization? We have an exceptional opportunity for an Assistant Director of Nursing (ADON) to join our team at The Laurels of Mt. ... Vernon. As Assistant Director of Nursing (ADON), you will assist the ...the industry. This includes: + Comprehensive health insurance - medical , dental and vision + 401K with matching funds… more
- Prime Therapeutics (Columbus, OH)
- …legislative/oversight bodies (eg, URAC-Utilization Review Accreditation Commission, CMS-Centers for Medicare & Medicaid Services, NCQA- National Committee for ... passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions -RPH/PharmD required- REMOTE **Job Description Summary**… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** Associate Director of Digital Experience Solutions (DES) Architecture In support of our vision to ... and to enable effectiveness and efficiency of technology decisions. The Associate Director of Digital Experience Solutions (DES) Architecture is a highly visible… more