- Humana (Columbus, OH)
- …our caring community and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... episodic, home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- 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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Conviva (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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… 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 ... and providers related to precertification, concurrent review, and appeal request. The medical director is a work-at-home position located anywhere in the US. The… 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 ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- 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 to complex issues where the analysis of situations or data requires an in-depth… more
- Elevance Health (Columbus, OH)
- …candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. ** Medical Director ** The ** Medical Director ** will be responsible ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. **How will… 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 ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- 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 ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied … more
- 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
- Elevance Health (Columbus, OH)
- **Clinical Ops Associate Medical Director ** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... analytics to improve the delivery of care. The **Clinical Ops Associate Medical Director ** is responsible for supporting the medical management staff… 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. The ... Corporate Medical Director works on problems of diverse scope and complexity...and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation… more
- Takeda Pharmaceuticals (Columbus, OH)
- …knowledge. **Job Description** **About the role:** Join Takeda as a Senior Medical Director , Pharmacovigilance in Gastrointestinal and Inflammation (GI2). You ... for presentations to the Takeda Safety Board and similar forums. The Senior Medical Director will be a key player in the preparation and presentation of… more
- Evolent (Columbus, OH)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , you will be a key member of the utilization management team. ... a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Elevance Health (Columbus, OH)
- **Clinical Ops Associate Medical Director - Ortho** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health ... to improve the delivery of care. The **Clinical Ops Associate Medical Director - Ortho** is responsible for performing pre-authorizations and providing quality… more
- Molina Healthcare (Columbus, OH)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... health and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management policies and procedures to improve… more
- Merck (Columbus, OH)
- **Job Description** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages in ... questions about Company products. The work of a Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support,… more
- Merck (Columbus, OH)
- …This person _must_ reside in the territory. **Role Summary** + The Oncology Regional Medical Scientific Director - Head & Neck Cancers/Melanoma is a credentialed ... questions about company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support,… more
- Merck (Columbus, OH)
- **Job Description** We are seeking a Growth and Improvement minded Regional Medical Scientific Director (AKA Medical Science Liaison / MSL) | in Inflammatory ... our Strategic Operating Priorities. **Summary, Focus and Purpose** The Regional Medical Scientific Director ( Medical Science Liaison) is a credentialed (ie,… more
- Merck (Columbus, OH)
- **Job Description** **Role Summary** + The Regional Medical Scientific Director (RMSD) is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease ... expert who engages in bidirectional exchange of scientific or medical information with Scientific Leaders (SLs). The role provides...RMSD serves as a role model for other field medical team members in ways that include on-boarding and/or… more