- Humana (Columbus, OH)
- …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical ... caring community and help us put health first** The Medical Director relies on medical ...Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare … more
- CVS Health (Columbus, OH)
- …a local Broker Manager to support the growth of our industry leading Medicare business in the Youngstown/Canton submarket. This is a highly collaborative role that ... will report to the Sales Director and drive local broker distribution and sales success....Prospects for and recruit's new brokers through collaboration with National and Direct agency relationships or through broker marketing… 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Columbus, OH)
- …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Director will learn National LTSS State ... community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical … 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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … 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 ... related to precertification, concurrent review, and appeal request. The medical director is a work-at-home position located...Two (2) + years of experience in managed care ( Medicare and/or Medicaid) Experience with managed care ( Medicare… 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
- 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
- Molina Healthcare (Columbus, OH)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- 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...compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
- Evolent (Columbus, OH)
- …Evolent 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. ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- 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 ... and post-acute providers, and payers in pursuit of improving outcomes and medical cost. Relationship goals include maximizing understanding of the ChenMed care… more
- CVS Health (New Albany, OH)
- …workflows to enhance accuracy and productivity. * Collaborate closely with the SIU Medical Director to align coding practices with organizational goals. * Work ... care more personal, convenient and affordable. **Position Summary:** As the Coding Director , you will oversee the coding operations, ensuring accurate and efficient… more
- 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
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard documentation, ... case studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities interrelate across… more
- NASCO (Columbus, OH)
- **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the company's ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Director , Consumer Experience ensures optimized interaction between Humana and its customers through ... both associate and consumer facing deliver on intended objectives. The Director , Consumer Experience ensures optimized interaction between Humana and its customers… more
- Humana (Columbus, OH)
- …will join the Health Quality and Stars (HQS) leadership team as the Director , Competitive Intelligence to drive the strategic vision of the company's Stars ... ideal candidate will possess a deep understanding of the Medicare landscape, strong analytical skills and the ability to...field + 8+ years of work experience in large national plans, strategic consulting, market analysis and/or finance +… more
- Humana (Columbus, OH)
- …community and help us put health first** The Risk Adjustment Compliance Director ensures compliance with governmental requirements. The Risk Adjustment Compliance ... Director requires an in-depth understanding of how organization capabilities...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic and ... the development of long-term growth plans and profitability goals The Director , Corporate Strategy, Long-Term Financial Planning oversees an organization's strategic… more