- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… 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
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… 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)
- **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
- Cleveland Clinic (Cleveland, OH)
- ** Medical Director , Pediatric Cardiac Intensive Care Unit** The Division of Cardiology & Cardiovascular Medicine within the Pediatric and Adult Congenital Heart ... clinical skills and a strong history of leadership to serve as the Medical Director of our Pediatric Cardiac Intensive Care Unit (PCICU). The position will have… more
- VCA Animal Hospitals (West Chester, OH)
- ** Medical Director - VCA Lakota Hills Animal Hospital** **West Chester, Ohio** VCA Lakota Hills Animal Hospital is seeking a ** Medical Director (DVM, ... like an owner would, **without the risks of ownership** . As Medical Director , you'll partner closely with Operations, Marketing, HR, and additional VCA support… 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 to ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- Elevance Health (Mason, OH)
- ** Medical Director -Dermatology Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law. The ** Medical Director -Dermatology Appeals** is responsible for the review of appeals for physical… more
- Parexel (Columbus, OH)
- …we are expanding our esteemed Medical Sciences Team and seeking an Associate/ Medical Director to support the growth of our Global Immunology and Inflammation ... Therapeutic Franchise. As an Associate / Medical Director , you will work closely with some of the best and brightest in the industry and assist our clients in… more
- 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 (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
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis of situations or data requires a case by case… more
- Evolent (Columbus, OH)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- The Medical Director , Nephrology & Immunology Medical Strategy is a critical role responsible for shaping the strategic processes and planning for assets in ... ability to balance competing priorities. This position reports directly to the Senior Director , Immunology Lead, who in turn reports to the Executive Director ,… more
- Elevance Health (Mason, OH)
- **Appeals Medical Director - Medicare** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... as required by law. Alternate locations may be considered. The **Appeals Medical Director ** is responsible for the appeal reviews for physical health medical… more
- Elevance Health (Mason, OH)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management** **Radiology Benefit Management/Utilization Review** **Virtual:** ... is granted as required by law._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the medical management staff… more
- Parexel (Columbus, OH)
- …Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to ... role can be based remo** t **ely in the US or Canada.** The Medical Director is a medical expert with specialized therapeutic expertise and some experience… more
- Centene Corporation (Columbus, OH)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve… more
- CVS Health (Columbus, OH)
- …And we do it all with heart, each and every day. **Position Summary** This Executive Medical Director - Medical Policy & Operations leads a team responsible ... Three (3) years or more of health plan/payor experience. Licenses: * Medical Director Board Certification is required * Active and current state medical… more