• Health-System Market Director…

    Cardinal Health (Columbus, OH)
    …team on prescribed medications, supplies and related processes. **_Job Summary_** The Market Director of Pharmacy provides overall regional leadership direction ... and management assistance of operation processes and initiatives within the...managers and staff. + Supports the Account Manager, Clinical Director , Market DOP colleagues, and client system… more
    Cardinal Health (10/23/25)
    - Related Jobs

  • National Accounts Medical Director

    Elevance Health (Cincinnati, OH)
    …clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... director provides clinical expertise in all aspects of utilization review and case management . Provides input...services by members. Involved in identifying and managing medical utilization trends, emerging trends and market changes… more
    Elevance Health (09/23/25)
    - Related Jobs

  • Medical Director - Medicaid Team - FL/SC

    Humana (Columbus, OH)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (10/28/25)
    - Related Jobs

  • Medical Director - Medicaid N. Central

    Humana (Columbus, OH)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (10/25/25)
    - Related Jobs

  • Part-time Behavioral Health Medical…

    Centene Corporation (Columbus, OH)
    …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
    Centene Corporation (10/23/25)
    - Related Jobs

  • Medical Director -Long Term Support…

    Elevance Health (Lima, OH)
    …clinical consultation and serve as clinical/strategic advisor to clinical operations including utilization management , care management and quality ... **Medical Director -Long Term Support and Services- MyCare OHIO**...services for target populations strongly preferred. + 1-2 years Utilization Management experience strongly preferred. + Strong… more
    Elevance Health (10/28/25)
    - Related Jobs

  • Medical Director - Mid West Region

    Humana (Columbus, OH)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
    Humana (09/16/25)
    - Related Jobs

  • Medical Director , Medical…

    Highmark Health (Columbus, OH)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
    Highmark Health (10/28/25)
    - Related Jobs

  • Medical Director , Behavioral Health (NE)

    Molina Healthcare (OH)
    …Duties * Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
    Molina Healthcare (10/23/25)
    - Related Jobs

  • Associate Director , Client Analytics

    Evolent (Columbus, OH)
    …leadership is preferred. + Familiarity with value-based care models and utilization management frameworks is preferred. Technical Requirements: We require ... of our specialty programs and administrative platform. Role Overview The Associate Director role on Client Analytics will support both internal teams (EAS, Specialty… more
    Evolent (10/29/25)
    - Related Jobs