- AmeriHealth Caritas (Dublin, OH)
- ** Utilization Management Plan Oversight Manager (Ohio Resident)** Location: Dublin, OH Primary Job Function: Medical Management ID**: 37872 **Job ... Officer for the Ohio Market, this position is representing Utilization Management (UM) in state interactions/audits, validation... program. + Act as a primary liaison with plan providers including but not limited to physicians, hospital… more
- CVS Health (Columbus, OH)
- …Plan . * Serving as the chair or co-chair of the Utilization Management committee and of the OhioRISE Plan 's internal quality improvement committee. * Play ... minimum of 32 hours per week to the OhioRISE Plan 's operations to ensure clinical oversight and...management , and quality improvement components of the OhioRISE Plan . * Developing, implementing, and interpreting medical policies and… more
- Humana (Columbus, OH)
- …and processes. + Experience in the clinical health care space, such as utilization management , pharmacy, care management , behavioral health. + Proficiency ... suited for this role. The Associate Director, Medicaid Implementation (Business Project Management ) will provide oversight to the development of solutions to… more
- CVS Health (Columbus, OH)
- …outcomes. * Leverage extensive knowledge of health care delivery system, utilization management , reimbursement methods and treatment protocols for DSNP/MMP ... Behavioral Health, Pharmacy, member outreach, Care Management , National Quality Management , Utilization Management , Compliance, and other departments to… more
- Battelle Memorial Institute (Columbus, OH)
- …Oversees development of major program plans covering the strategic business plan , technical content, program management best practices, program acquisition ... function of dollar volume or contract length. Provides successful leadership and management to programs with high client and/or Battelle impact and investment.… more
- Merck (Columbus, OH)
- …+ Reviewandapprovetimesheets,GTTcompliance,expensereports,time‐offrequests and provide proper oversight of CTC's productivity/ utilization . ... **Job Description** This role is accountable for execution and oversight of local operational clinical trial activities in compliance with ICH/GCP and country… more
- CVS Health (Columbus, OH)
- …OhioRISE program. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management ... and clinical coverage and policies. The Manager is responsible for oversight and management of clinical team processes including the organization and development… more
- Elevance Health (Columbus, OH)
- …preferred (such as GA, IN, and KS). + Experience in Injectable/Specialty Drug oversight including Drug Utilization Management preferred. + Experience with ... The **Pharmacist Clinical** is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs. **Primary duties may… more
- Verint Systems, Inc. (Columbus, OH)
- …of Job Function:** Responsible for the strategic direction, alignment, design and oversight of all benefit plans for US, Canada, Mexico and Brazil employees. ... ongoing analysis of the health benefits strategy - including plan design, pricing strategy, administration, compliance, communications, implementation and… more
- Prime Therapeutics (Columbus, OH)
- …Excellent verbal and written communication skills. + Knowledge of legislative/ oversight bodies (eg, URAC- Utilization Review Accreditation Commission, CMS-Centers ... client presentations + Leads evaluation and identification opportunities for improved management of Medical benefit drugs through clinical research and analytics… more
- Burns & McDonnell (Columbus, OH)
- …contracts, subcontractors, suppliers, proposals, estimates, documentation turnover, client relations/ management , field staff and other duties required to execute ... EPC, Construction Management , Construction, and Program Management projects. Experience...project team members and subcontractors. + Responsible for the oversight of day-to-day construction activities and the successful execution… more
- RES (Columbus, OH)
- …of mechanics, shop aligned and site/field-based, and is responsible for oversight , direction, troubleshooting, diagnosing and high-quality repairs on heavy equipment ... routine maintenance schedules and communicates schedules for maintenance, repairs and utilization to Equipment Manager and field personnel. + Reviews third (3rd)… more
- Battelle Memorial Institute (Columbus, OH)
- …Toxicologist functions as a study director within the organization and has oversight of the scientific elements of projects to ensure successful implementation ... projects/research. This position may also be responsible for the supervision, oversight , scheduling, training, and mentoring of individuals within Battelle's Life… more
- Marriott (Columbus, OH)
- …posture. + Provide governance support for the analytics platforms such as platform management standards and change oversight . + Support budgeting work with ... States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** We are seeking a highly skilled and experienced… more
- Post Holdings Inc. (West Jefferson, OH)
- …forecasting and full P&L responsibility for the location. This role has oversight of accounts payable, inventory costing, and SOX compliance. The Controller is ... Payable. Lead development of monthly forecasts, and the Annual Operating Plan . Maintain customer relationship related to financial aspects including pricing and… more
- J&J Family of Companies (Columbus, OH)
- …products. The TM approaches each customer from a total account management perspective, by leveraging resources appropriately, collaborating with internal and ... partners, including stakeholders such as HCPs, Administrators, C-Suite, Quality, Case Management , and other emerging influencers. DUTIES & RESPONSIBILITIES Under (eg… more
- Battelle Memorial Institute (West Jefferson, OH)
- …Summary** The Manager, Facilities Alterations, Operations & Maintenance provides oversight of the Facilities Alterations, Operations and Maintenance Department which ... provides services such as building automation controls and energy management , electrical construction and distribution, utilities, mechanical systems repairs and… more
- Prime Therapeutics (Columbus, OH)
- …overall client relationship. Participates in the development of clinical management products and services. Activities address impact on customers, operations, ... programs integrate with other clinical initiatives, and expertise with data management . **Job Description** + Leads the development of clinical program enhancements… more
- BJs Wholesale Club (Lewis Center, OH)
- …needs* o Three medical plans**, Health Savings Account (HSA), two dental plans, vision plan , flexible spending * 401(k) plan with company match (must be ... in the execution and delivery of exceptional service and value. Provide TM oversight and direction to exceed performance expectations and results in each area… more
- Prime Therapeutics (Columbus, OH)
- …use of innovative actuarial modeling concepts. This position will provide direct oversight to both the rebate and trend projection process, including recommendations ... complex actuarial modeling + Collaborates with underwriters, client engagement, and senior management on RFP process and other pricing initiatives related to all… more