- Humana (Columbus, OH)
- **Become 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Columbus, OH)
- **Become 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- CVS Health (Columbus, OH)
- …We are looking for a Principal Data Scientist to join our Aetna Medicare (STARS Portfolio) team at CVS Health. This high-level individual contributor will partner ... closely with the Executive Director of Aetna STARS Analytics to drive hands on...business strategies and products + Experience in large, matrixed corporate environment + Experience working with end-users **Education:** +… more
- Humana (Columbus, OH)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Columbus, OH)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Columbus, OH)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- 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 ... and regulatory, corporate , and divisional objectives. Provides oversight of corporate audit and reporting teams supporting all Medical Mutual lines… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s status as a ... Founded in 1934, Medical Mutual is the oldest and one of...of Directors and Management. . Performs an annual overall corporate risk assessment and develops specific audit plans tailored… more
- Cleveland Clinic (Cleveland, OH)
- …compliance concerns related to billing compliance. + Communicate to the Executive Director of Corporate Compliance any matter that potentially requires external ... the most respected healthcare organizations in the world. The Director of Billing Compliance plays a crucial role in...hospital reimbursement. + Attend and present to the CCHS Corporate Compliance Committee and other audiences as requested. +… more
- Molina Healthcare (Columbus, OH)
- …Tighter knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates Complex Provider contracts including but not ... and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract… more
- ChenMed (Cincinnati, OH)
- …+ Implements strategic planning for referral coordination that contributes to medical cost reduction and improves organizational performance. + Interviews Referral ... Manager candidates. Maintains and promotes the awareness of the corporate values to help develop Referral Managers for career growth and future success. + Gives… more
- Gentiva (Dunbridge, OH)
- …diagnosis, treatment, consultation, and follow-up under the direction of the Palliative Medical Director or Primary Care physician. **As a Nurse Practitioner, ... tests within the scope of professional practice. Order treatments and durable medical equipment as indicated. + Communicate clinical findings to the PSC Physician… more