• Medicare Medical Director

    Elevance Health (Independence, OH)
    ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
    Elevance Health (01/08/25)
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  • Medical Director

    Molina Healthcare (Cleveland, OH)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (01/13/25)
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  • Director -Rehab PTA

    Genesis Healthcare (Lyndhurst, OH)
    …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... our Clinicians in Action professional development program. Responsibilities The Director of Rehab PTA is responsible for the efficient...period of one year. 5. A thorough knowledge of Medicare and third party billing is also required. Genesis… more
    Genesis Healthcare (01/10/25)
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  • Director , SIU / Fraud Waste and Abuse…

    Molina Healthcare (Cleveland, OH)
    …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
    Molina Healthcare (01/13/25)
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  • Therapist-Sr PT

    Genesis Healthcare (Shaker Heights, OH)
    …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... better, and living better. The Senior Therapist is responsible for assisting the Director of Rehab in the efficient Clinical management of rehabilitation services in… more
    Genesis Healthcare (01/10/25)
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  • Pharmacist, Clinical/MTM

    Molina Healthcare (Cleveland, OH)
    …therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics ... + Provides medication therapy management including examination of member medical records, performing a comprehensive medication review, and communicating with… more
    Molina Healthcare (01/13/25)
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  • Patient Care Manager, RN - Full Time

    Gentiva (Independence, OH)
    …in the **Cleveland/Independence** area. You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible ... referrals/inquiries in a timely, professional, and compassionate manner, including triage of medical concerns within scope of practice. + Preparing for, serving on,… more
    Gentiva (01/13/25)
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