• Behavioral Health Medical

    Humana (Columbus, OH)
    **Become a part of 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 to complex issues where the… more
    Humana (02/15/25)
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  • Behavioral Health Navigator

    CVS Health (Columbus, OH)
    …make health care more personal, convenient and affordable. **Position Summary:** The Behavioral Health Navigator is a clinical leader in the Medicaid plan ... key stakeholders, community organizations, advocacy groups as well as the OhioRISE Medical Director and senior leadership team to enhance the quality… more
    CVS Health (03/08/25)
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  • Medical Director Aetna Duals Center…

    CVS Health (Columbus, OH)
    …Michigan, Virginia, Pennsylvania, and New Jersey offering a variety of physical and behavioral health programs and services to its membership. Aetna is looking ... Bring your heart to CVS Health . Every one of us at CVS Health shares...for a medical director to be part of a centralized team that supports the … more
    CVS Health (02/08/25)
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  • Medical Director

    Centene Corporation (Columbus, OH)
    …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
    Centene Corporation (02/23/25)
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  • Product Lifecycle Strategy Director

    Elevance Health (Columbus, OH)
    …delivered high-impact results for over 150 years. With capabilities spanning pharmacy, behavioral health , complex care delivery, medical benefits management, ... teams involved in Utilization Management, Specialty Benefits Management, Payment Integrity, Advocacy, Health Plan Subrogation, Behavioral Health , Health more
    Elevance Health (03/13/25)
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  • Part-Time Weekend Medical Director

    Highmark Health (Columbus, OH)
    …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
    Highmark Health (03/14/25)
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  • Medical Director Pharmacy,…

    Highmark Health (Columbus, OH)
    **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This role leads a Pharmacology & Therapeutics Committee and serves as a Medication ... requested. . **Q** **UALIFICATIONS:** **Required** + Doctorate degree in Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (01/16/25)
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  • Director , Network

    ChenMed (Columbus, OH)
    …specialists, hospital providers, and post-acute providers, including skilled nursing facilities, home health , behavioral health , social service, and other ... we need great people to join our team. The Director , Network is to be the business and clinical...providers, and payers in pursuit of improving outcomes and medical cost. Relationship goals include maximizing understanding of the… more
    ChenMed (03/05/25)
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  • Director of Rating Tools Enablement

    Highmark Health (Columbus, OH)
    **Company :** Highmark Health **Job Description :** **JOB SUMMARY** Highmark seeks a Director of Rating Tools Enablement to lead the design, development, and ... Oversee the execution of analytics to support the implementation of key medical cost savings initiatives: Understand the insights required to capture cost-savings,… more
    Highmark Health (03/15/25)
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  • Director Reimbursement Design & Market…

    Highmark Health (Columbus, OH)
    …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Advanced Analytics, Contracting and Provider Relations, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
    Highmark Health (03/04/25)
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  • Director Provider Reimbursement Development

    Highmark Health (Columbus, OH)
    …initiatives. These functions collectively maintain the Organization's reimbursements to all health care providers, and serve as a consulting resource in maintaining ... in reimbursement and payment model design + Familiarity with core health plan reimbursement operations **_Preferred_** + Familiarity with alternative care model… more
    Highmark Health (03/04/25)
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  • Associate Director I

    Compass Group, North America (Columbus, OH)
    …platform includes the latest in healthful eating and an understanding of behavioral change in food consumption. Morrison's alignment with Partnership for a Healthier ... Nutrition Services in an Acute Care Hospital. The Associate Director of Food and Nutritional Services will assist in...at Morrison Healthcare are offered many fantastic benefits. + Medical + Dental + Vision + Life Insurance/ AD… more
    Compass Group, North America (03/13/25)
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  • Executive Director , Compliance

    NASCO (Columbus, OH)
    …Cross Blue Shield Medical , Dental, and Vision Plans + Telehealthcare - for Medical and Behavioral visits + Generous PTO with buy/sell options + 9 Company ... **Overview** As Executive Director , Compliance you will lead and provide oversight...is designed to support the physical, mental, and financial health of our associates. We offer: **Physical and Mental… more
    NASCO (02/11/25)
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  • Clinical Research Director (CRD) - General…

    Merck (Columbus, OH)
    **Job Description** The Clinical Research Director (CRD) is the Clinical Operations lead in a country/cluster and is responsible for execution of all Clinical Trials ... Research & Development Division / GCD Therapy Areas, and when appropriate Human Health . + Working with regional and global colleagues develops and executes the GCTO… more
    Merck (03/19/25)
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  • IPA Coding Associate Director

    CenterWell (Columbus, OH)
    …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
    CenterWell (03/06/25)
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  • Senior Clinical Strategist - OhioRISE

    CVS Health (Columbus, OH)
    …Management, Quality Management, and Medical Management on issues related to Behavioral Health . Further, the incumbent functions as the Behavioral ... Provider Relations, Member Services, Operations and Network. This position supports the Behavioral Health Clinical Director , Chief Clinical Oversight… more
    CVS Health (03/21/25)
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  • Nurse Manager / RN Required

    BrightSpring Health Services (Columbus, OH)
    …mortality reviews are completed within five days of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review ... Community Living, Adult Host Homes for adults regardless of disability, Behavioral /Mental Health Support, In-home Pharmacy Solutions, Telecare and Remote… more
    BrightSpring Health Services (02/20/25)
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  • Clinical Services Manager - Service Reception

    National Youth Advocate Program (Columbus, OH)
    …and clinical therapists on case consultation with the development and growth of behavioral health and outpatient mental health services. **Responsibilities** ... Repayment assistance** , up to $1,200 per year! + Medical , Dental, and Vision + **22 Days Off** Each...+ Lead the application of evidence-informed service modalities in behavioral health service delivery for the Service… more
    National Youth Advocate Program (02/17/25)
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  • Staff Psychologist

    Veterans Affairs, Veterans Health Administration (Columbus, OH)
    …advice and consultation in areas related to professional psychology and behavioral health . Knowledge of clinical research literature. Preferred Experience: ... VA Careers - Psychologist: https://youtube.com/embed/77qHlLw9Xck Total-Rewards-of-an-Allied- Health -VA-Career-Brochure.pdf Psychologist: vacareers.va.gov/wp-content/uploads/sites/5/Total-Rewards-of-a-Psychology-Career-Flyer.pdf At the… more
    Veterans Affairs, Veterans Health Administration (03/18/25)
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  • Senior Pharmacist

    Highmark Health (Columbus, OH)
    …of member specific information to improve individual outcomes as an adjunct to health coaching. If acting in the capacity as a clinical pharmacist the incumbent ... disease management identification process, and consult with the Organization's Associate Medical Directors and Medical Directors when appropriate, follow-up on… more
    Highmark Health (02/21/25)
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