- Cardinal Health (Columbus, OH)
- …+ Experience in a managed services, physician enterprise, or oncology practice management setting + Familiarity with payer models, oncology value-based ... experienced team is passionate about helping oncology practices navigate the future. The Director of Practice and Network Strategy will be responsible for… more
- Humana (Columbus, OH)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more
- Humana (Columbus, OH)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more
- Humana (Columbus, OH)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in ... management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- CenterWell (Columbus, OH)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilizationmanagement experience in a medical ... toadaptand the courage to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical … more
- Humana (Columbus, OH)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more
- Humana (Columbus, OH)
- …managed care industry, Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare... management review organization such as Medicare Advantage, managed Medicaid, or Commercial health insurance + 5+ years… more
- Molina Healthcare (Dayton, OH)
- …HEDIS, Medicaid, Medicare and Pharmacy benefit management , Group/IPA practice , capitation, HMO regulations, managed healthcare systems, quality improvement, ... including: + 2 years previous experience as a Medical Director in a clinical practice . + Current..., and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE,… more
- Highmark Health (Columbus, OH)
- …**Required** + 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice ) **Preferred** + 1 year in Medical Management in a Health ... as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest...Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical… more
- Cleveland Clinic (Cleveland, OH)
- …or multi-specialty practice settings + Seven years of leadership or management role within a healthcare system or contracting department + Deep understanding of ... one of the most respected healthcare organizations in the world. The Director of Payer Contracting - Ambulatory, Transplant, and Ancillary Services leads national… more