- Elevance Health (Mason, OH)
- …to their supervisors attention, any case review decisions that require + Medical Director review or policy interpretation. **Minimum Requirements:** + ... **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management** **Radiology Benefit Management/ Utilization Review **… more
- Elevance Health (Mason, OH)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Molina Healthcare (Cincinnati, OH)
- …Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous ... Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review... medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in… more
- Highmark Health (Columbus, OH)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may… more
- Select Medical (Cleveland, OH)
- …Performs basic chart review activities with appropriate staff for outcome utilization , infection control and medical CQI indicators. Analyzes results of ... **Overview** **Cleveland Clinic Rehabilitation Hospital - Fairhill** ** Director of Quality Management** **(DQM)** **Opening in October, the Cleveland Clinic… more
- Travelers Insurance Company (Columbus, OH)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical ...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- Bon Secours Mercy Health (Toledo, OH)
- …clinicians are recognized for clinical and operational excellence. The Director of Institutional Effectiveness provides strategic leadership for institutional ... assessment and research. The Director plays a critical role in supporting the Mercy College mission as a healthcare-focused institution offering rigorous… more
- Cardinal Health (Columbus, OH)
- …medications, supplies and related processes. **_Job Summary_** The Market Director of Pharmacy provides overall regional leadership direction and management ... standards, State and Federal legal requirements, distribution systems, automation, utilization patterns, and computer systems. Interfaces with system and local… more
- Concentrix (Columbus, OH)
- Job Title: Director , Specialty Sales, iX Product Suite Job Description At Concentrix, we partner with the world's most customer-obsessed companies to conceive, ... for how technology is transforming the world. **Specialty Sales Director , iX Solutions - AI** Concentrix is looking for...+ Expert business knowledge with invoicing, SOWs, margins, and utilization **Qualifications** + Minimum of 3 years selling AI… more
- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job Description** ... The Senior Director Clinical Strategy and Oncology Specialty Solutions is responsible...the development of strategic business roadmaps that integrate both medical and pharmacy solutions. This position will provide leadership… more