- Humana (Columbus, OH)
- …Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical ... + Other activities as assigned by the managing Medical Director Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. ... The Corporate Medical Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about… more
- Humana (Columbus, OH)
- …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...medical management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Experience with national… more
- Humana (Columbus, OH)
- …our caring community and help 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...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Must be passionate… more
- Elevance Health (Mason, OH)
- **Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model ( remote and ... home-care and community based services. The **Clinical Document Improvement Director ** is responsible for leading encounter processing, diagnostic documentation and… more
- Sanofi Group (Cincinnati, OH)
- **Job Title:** Regional Account Director , OH **Location:** Remote /Field Based **About the Job** The Regional Account Director reports to the Regional ... specialty pharmacies, Regional PBMs, targeted ACO, targeted IDNs, MACs and state Medicaid agencies, to achieve and maintain open and appropriate access to all… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Associate Director , Learning Design uses instructional design, cognitive psychology and adult learning theory ... solution to a knowledge or performance gap. The Associate Director , Learning Design requires a solid understanding of how...**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Associate Director , Business Intelligence solves complex business problems and issues using data from ... and external sources to provide insight to decision-makers. The Associate Director , Business Intelligence requires a solid understanding of how organization… more
- Humana (Columbus, OH)
- …are seeking an accomplished healthcare physician leader for the newly-created role of Director , Physician Leadership. In this role, you will be a key enterprise ... health outcomes for some of our most vulnerable members. The Director , Physician leadership will lead Medical Directors performing utilization management for… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …excellence. ** DIRECTOR MANAGED CARE CONTRACTING - LARGE ACCOUNTS** **| REMOTE ** This position is responsible for developing, managing, and leading the day-to-day ... standards and directives regarding governmental/third party agencies (Medicare & Medicaid ) and/or third paLeads assigned negotiations of fee for service,… more