- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Columbus, OH)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Columbus, OH)
- …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Evolent Health (Columbus, OH)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
- Elevance Health (Columbus, OH)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... This high-performing individual contributor will be responsible for working with management to identify and implement varied projects, programs and plans that… more
- Elevance Health (Columbus, OH)
- …responsibility for Program Management and/or Medicare Integrity Operations. + Program Management includes but is not limited to: Claims , Grievance & Appeals, ... ** Director I Medicare Operations** **Location:** This position will...years professional/leadership experience with CMS, including strategic planning, project management , Medicare or related healthcare insurance or medical… more
- J&J Family of Companies (Columbus, OH)
- …safety data, international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and implements ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...position is to lead the implementation of the Signal Management Group's aggregate surveillance strategies for proactive and systematic… more
- Cardinal Health (Columbus, OH)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Sumitomo Pharma (Columbus, OH)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
- Takeda Pharmaceuticals (Columbus, OH)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Evolent Health (Columbus, OH)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Sedgwick (Columbus, OH)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director SAP Program **PRIMARY PURPOSE** **:** Directs the strategic planning, ... of SAP FICO and BRIM Solution Components, including Subscription Order Management (SOM), Convergent Charging (CC), Convergent Invoicing (CI), Contract Accounting… more
- Evolent Health (Columbus, OH)
- …models using healthcare data (ie, both structured and unstructured data from operations, claims , and medical charts) to solve complex problems, drive innovation, ... in everything from scrubs to jeans. **Position summary** As an Associate Director , Data Scientist (Machine Learning Engineer), you will be responsible for… more
- HomeSafe Alliance (Columbus, OH)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- Prime Therapeutics (Columbus, OH)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more
- The Ruhlin Company (Columbus, OH)
- …owners. Bridge Experience Necessary Position Responsibilities: Safety + Work with the Safety Director to ensure jobs have safe working conditions and that safe work ... cost set-up and project pre-planning. + Work with the Director of Operations or Division Manager to staff the...or plans as required; prepare project reports for Company management , owners, or others. + Manage the scope of… more
- Evolent Health (Columbus, OH)
- …leaders across the organization, training and development, provider relations, member services, claims management and our implementation team will also be ... plans and serves in a supporting role to the Director , Intake and Utilization Management Operations. +...population management or managed care/insurance or hospital medical management department setting may be substituted… more
- Amgen (New Albany, OH)
- …that support capital projects, including Engineering Technical Authority, Project Management , Facilities Management , Global Site Engineering, Capital Finance, ... including compliance to processes and policies. + Assisting Project Controls Director in developing project strategies and associated financing + Working closely… more
- Prime Therapeutics (Columbus, OH)
- …value based contracts, provider accountable care organization pharmacy metrics, medical policy, utilization management , medication adherence, and medication ... learning, predictive modeling, and reporting for complex pharmacy and medical health insurance clinical programs and services (eg, pharmaceutical manufacturer… more