- Highmark Health (Columbus, OH)
- …responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using ... Medical Policy criteria sets to evaluate the ... necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic… more
- Elevance Health (Cincinnati, OH)
- …our care management models for our National Account clients. The medical director will be responsible for supporting the clinical vision and implementation ... the health improvement tools offered to clients/ members. The medical director provides clinical expertise...clinical relevance to account reporting regarding use of medical services by members. Involved in identifying… more
- Humana (Columbus, OH)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the… more
- Molina Healthcare (Cincinnati, OH)
- …Board Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... case management programs for mental health and chemical dependency services . Works closely with the Regional Medical ...* Supports BH committees for quality compliance. * Implements clinical practice guidelines and medical necessity review… more
- MetroHealth (Cleveland, OH)
- …physician for the Cuyahoga County Corrections Center Health Services Program. The Medical Director will provide clinical oversight of all medical ... **The MetroHealth System is seeking a Medical Director to lead the provider team and clinical...clinical direction of the Cuyahoga County Corrections Center Medical Services that MetroHealth provides for the… more
- Molina Healthcare (Cleveland, OH)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. ... and procedures that guide and support the provisions of medical staff services . Maintains a working knowledge...experience, including: + 2 years previous experience as a Medical Director in a clinical … more
- Cleveland Clinic (Cleveland, OH)
- …to the Cleveland Clinic Center for Functional Medicine + Working closely with the Medical Director in clinical program development and implementation + ... optimize the patient care experience + Providing feedback to Medical Director and Practice Administrator on effective...regular responsibilities of a CC physician, including: + Providing medical services in the general care and… more
- Bellefaire JCB (Shaker Heights, OH)
- …"Bellefaire JCB: Join Our Team" (https://vimeo.com/894121531) on Vimeo! POSITION SUMMARY: The Clinical Director of Residential Autism Services is responsible ... Autism Services division of Bellefaire JCB. The Clinical Director , free from the constraints and...the constraints of billing requirements, prior authorizations, and determining medical necessity of services for third-party payors.… more
- OhioHealth (Columbus, OH)
- …- in our careers and in our communities. **Job Description Summary:** The Clinical Enterprise Director will have operational and strategic responsibilities for a ... be responsible for the ongoing operational execution of defined service line clinical programs, engaging with highly...administrative leadership teams to drive successful efforts to support service line, medical group, and care site… more
- Cleveland Clinic (Cleveland, OH)
- The Center for Neurological Restoration at the Cleveland Clinic is recruiting for a Director of Clinical Research in Headache and Facial Pain to join our ... Center for Neurological Restoration is one of the largest clinical programs in the country, with unlimited clinical... trials and research program of the Section. The Director of Research will have the support of a… more