- Premier Health (Dayton, OH)
- …**FT/ DAYS/ 80 hours per pay** **Summary of Position** The Physician Contracting Specialist will collaborate with the Director of Physician ... and analyze legal documents accurately and efficiently. 3. Assist the Director of Physician Contracting and operational leadership with the preparation of… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …care sites and clinicians are recognized for clinical and operational excellence. ** DIRECTOR MANAGED CARE CONTRACTING - LARGE ACCOUNTS** **| REMOTE** This ... developing, managing, and leading the day-to-day activities associated with managed care contracting for both fee for service and risk agreements within a specified… more
- The Cigna Group (Independence, OH)
- …LOCATION: Must reside in the Cleveland or Independence, OH area.** The ** Director ** **,** **Provider Contracting Network Management** serves as an integral ... member of the Provider Contracting Team and reports to the Provider ...and other providers (eg, Hospital systems, Ancillaries, and large physician groups). + Builds relationships that nurture provider partnerships… more
- Humana (Columbus, OH)
- …be their most productive. Against that backdrop, we are seeking an accomplished healthcare physician leader for the newly-created role of Director , Physician ... improving health outcomes for some of our most vulnerable members. The Director , Physician leadership will lead Medical Directors performing utilization… more
- Molina Healthcare (Cleveland, OH)
- …from government and accreditation regulators. + Directs the team in providing physician leadership and expertise in the performance of prior authorization, inpatient ... Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous leadership… more
- Molina Healthcare (OH)
- …activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, ... Improvement activities. + Stabilizes, improves and educates the Primary Care Physician and Specialty networks. Monitors practitioner practice patterns and recommends… more
- Travelers Insurance Company (Columbus, OH)
- …Will You Do?** + Provide overall program leadership as the organization's lead physician . Serve as the key enabler and facilitator for the Travelers medical ... input and support medical vendor strategies including vendor selection, negotiation and contracting . + Medical Direction and Oversight: + Participate in the design… more
- Holzer Health System (Gallipolis, OH)
- The Registered Nurse will work under the supervision of the Director of Hospice. Performs skilled nursing care using the nursing process to meet the age-specific ... hospice patients and families as indicated by protocols and physician orders. * Utilizes the nursing process to deliver...and presenting cost saving ideas to the supervisor and/or Director . * Performs patient and staff education. * Participates… more
- Sanofi Group (Cincinnati, OH)
- …customers. In this field-based position, the FRM will report to a field-based Director , Field Reimbursement, within Patient Support for T1D (Type 1 Diabetes). The ... payer policy requirements and billing codes + Provide support in triaging contracting , billing and coding, access and procurement questions and other issues where… more
- Molina Healthcare (Cincinnati, OH)
- …request/provider inquiries, such as eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits ... phone, fax, and mail according to Molina operational timeframes. + Contacts physician offices according to Department guidelines to request missing information from… more