• Medical Director - Medicare

    Elevance Health (Columbus, OH)
    ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
    Elevance Health (05/20/25)
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  • Corporate Medical Director…

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
    Humana (04/24/25)
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  • Medical Director ( Medicare )

    Molina Healthcare (Dayton, OH)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (05/02/25)
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  • Medical Director - Medicare…

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
    Humana (05/14/25)
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  • Medical Director - Care Plus…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (04/24/25)
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  • Medical Director - Pacific SW Region

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (05/10/25)
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  • Medical Director - Medicaid N.…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
    Humana (05/14/25)
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  • Medical Director , MSK Surgery

    Evolent (Columbus, OH)
    …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (05/20/25)
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  • Medical Director Specialty…

    Molina Healthcare (Cincinnati, OH)
    **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
    Molina Healthcare (04/09/25)
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  • Director , TPA & Dental Service Operations

    Medical Mutual of Ohio (Brooklyn, OH)
    …overseeing all activities related to the third-party administration of self-funded medical , dental, and specialty benefits. Additionally, the Director ... with additional in-office presence as needed._** Founded in 1934, Medical Mutual is the oldest and one of the...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.… more
    Medical Mutual of Ohio (05/03/25)
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