• Associate Director - Value-Based…

    Humana (Columbus, OH)
    …part of our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard ... to contract templates, language negotiations, processes, and resources. The Associate Director for Value-Based Specialty and Vendor Support's decisions are… more
    Humana (03/04/25)
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  • Physician Medical Director - LTSS

    Humana (Columbus, OH)
    …community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical ... necessity of a given service, level of care, or medical item/supply. The Medical Director 's...DO degree + Board Certified in an approved ABMS Medical Specialty + Excellent communication skills with… more
    Humana (01/25/25)
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  • Medical Director Aetna Duals Center…

    CVS Health (Columbus, OH)
    …robin based on "same or similar specialty " needs. * Pharmacy coverage - The medical director will perform pharmacy reviews. * The medical director ... services to its membership. Aetna is looking for a medical director to be part of a...DO; Board certification in an ABMS or AOA recognized specialty is required. Active and current state medical more
    CVS Health (02/08/25)
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  • Medical Director - Medicaid N.…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...Current and ongoing Board Certification in an approved ABMS Medical Specialty + **A current and unrestricted… more
    Humana (03/11/25)
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  • Medical Director - Care Plus…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...+ Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted… more
    Humana (03/18/25)
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  • Field Medical Director , Cardiology

    Evolent (Columbus, OH)
    …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (02/14/25)
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  • Medical Director - National Medicare…

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...Current and ongoing Board Certification in an approved ABMS Medical Specialty + A current and unrestricted… more
    Humana (03/11/25)
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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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  • Medical Director - Commercial…

    CVS Health (Columbus, OH)
    …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Management staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for… more
    CVS Health (03/20/25)
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  • Field Medical Director

    Evolent (Columbus, OH)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (01/30/25)
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  • Behavioral Health Medical Director

    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...of Osteopathy . **Board-certified in ABMS or ABPN recognized specialty ** **of Psychiatry** . A current and unrestricted license… more
    Humana (02/15/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Columbus, OH)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
    Molina Healthcare (02/06/25)
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  • Field Medical Director , Genetic…

    Evolent (Columbus, OH)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Genetic Testing you will be a key member of the utilization ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...+ Current, unrestricted clinical license in medicine or required specialty + Obtaining and maintaining medical licenses… more
    Evolent (02/18/25)
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  • Director of Medical Education

    Trinity Health (Grove City, OH)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Director of Medical Education** **Position Purpose:** The Director of Medical ... System. The DME is a primary liaison with administrative leaders, the medical staff, affiliated training institutions on matters relating to graduate medical more
    Trinity Health (01/23/25)
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  • Associate Medical Director

    Evolent (Columbus, OH)
    …for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you ... to drive meaningful change beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in… more
    Evolent (03/04/25)
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  • Medical Director

    Highmark Health (Columbus, OH)
    …Doctor of Osteopathic Medicine (DO) + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the ... American Osteopathic Association Specialty Certifying Boards + Active medical state licensure required. Additional specific state licensure(s) may be required… more
    Highmark Health (03/20/25)
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  • Director , Network

    ChenMed (Columbus, OH)
    …We're rapidly expanding and we need great people to join our team. The Director , Network is to be the business and clinical relationships partner to the Regional ... President, Market Operations and Clinical leaders, Specialty leaders, and Hospital and Community Care Team and...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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  • Specialty Pharmacy Accreditation…

    Cardinal Health (Columbus, OH)
    …& Operations Support Specialist contributes to Cardinal Health_** Reporting to the Director of Specialty Pharmacy Operations, the Specialty Pharmacy ... experience in helping hundreds of hospital, outpatient, clinic, and specialty pharmacies, we provide access to best practice strategies...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
    Cardinal Health (02/20/25)
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  • Center Clinical Director , Associate

    ChenMed (Columbus, OH)
    …expanding and we need great people to join our team. The Clinical Director will directly supervise and train primary care providers (PCPs) in his/her assigned ... needs, size of centers, patient membership, and Market Clinical Director direction. **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Independently provides care for… more
    ChenMed (01/11/25)
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  • Trade Client Relations Director Sr

    Prime Therapeutics (Columbus, OH)
    …and drives every decision we make. **Job Posting Title** Trade Client Relations Director Sr **Job Description** The Trade Client Relations Senior Director is ... responsible for proactively bringing innovative pharmacy and medical rebate strategies and cost saving solutions to Prime's...care to its members. The Trade Client Relations Senior Director has an in depth understanding of Prime's strategic… more
    Prime Therapeutics (03/04/25)
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