- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
- Molina Healthcare (OH)
- **_ Remote and must live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Plans, organizes,… more
- CVS Health (OH)
- …compassionate. And we do it all with heart, each and every day. **Position Summary** MUST RESIDE IN OHIO The Care Management Associate (CMA) role is a full-time, ... possess reliable transportation and be willing. Qualified candidates must reside in Ohio. This position manages...service delivery under the direction of nurse or medical director in the most appropriate setting at the most… more
- Molina Healthcare (OH)
- …to travel within Ohio. **PREFERRED EXPERIENCE:** + 10+ years **STATE SPECIFIC REQUIREMENTS:** + Must reside in Ohio. To all current Molina employees: If you are ... **JOB DESCRIPTION** **JOB SUMMARY** : The Program Director leads strategic initiatives to enhance the direct...and monitors system analysis and program staff. This role must have strong management and leadership skills; should be… more
- Evolent (Columbus, OH)
- …Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can ... in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission… more
- Evolent (Columbus, OH)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can ... in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission… more
- Evolent (Columbus, OH)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology to ... in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission… more
- Merck (Columbus, OH)
- **Job Description** The Virology (HIV) Regional Medical Scientific Director is a credentialed (ie, MD, PhD, DNP, or PharmD) therapeutic and disease area expert who ... travel up to 50% of the time overnights and reside in the coverage region **Skills Required:** + Deep...the pharmaceutical industry and its external stakeholder environment + Must be able to organize, prioritize, and work effectively… more
- Evolent (Columbus, OH)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...Obtaining and maintaining medical licenses in the state you reside and any required per business needs- **Required** +… more
- Sanofi Group (Cincinnati, OH)
- …may be required within the assigned region or nation + Valid driver's license + Must reside within the geographic area of the assigned region **Why Choose Us?** ... **Job Title:** Regional CPE Director , Tzield Great Lakes/Mideast **Location:** Remote, US **About...business objectives + Maintain strict adherence to all legal, compliance , regulatory, ethical, administrative, and financial duties **About You**… more
- Compass Group, North America (Canton, OH)
- …goal is to achieve operational and financial goals in a dynamic environment. ** MUST RESIDE ** within 30 minutes of **Cleveland, OH** . **Key Responsibilities:** ... service team members. **Job Summary** Working as a **Regional Director of Operations (RDO)** you will lead, manage, and...with key partners to support regional initiatives + Ensures compliance with QA, policy, and USDA program requirements, along… more
- Evolent (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Physical Medicine and Rehab you will be a key member of the utilization ... in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission… more
- Evolent (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization management team. We ... in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission… more
- Evolent (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management team. We ... in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission… more
- The Cigna Group (Cleveland, OH)
- **WORK LOCATION: Must reside in the Cleveland or Independence, OH area.** The ** Director ** **,** **Provider Contracting Network Management** serves as an ... to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance , Sales and Marketing and Service. + Manages strategic positioning… more
- Nelnet (Columbus, OH)
- …hybrid work schedule includes 24 hours of in-office work each week, for associates that reside within 30 miles of an office. This is subject to change, based on ... time, we are unable to move forward with external candidates that reside in these states: Alabama, California, Connecticut, Hawaii, Illinois, Maine, Massachusetts,… more
- Humana (Dayton, OH)
- …an impact** **Required Qualifications** + **Active Health Insurance License** required. + Must reside in **the designated local territory** to effectively serve ... Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Trinity Health (Columbus, OH)
- …about operational excellence. **Location:** Columbus, OH (On Site) and Mishiwaka, IN (Virtual) **Candidate must reside in Central Ohio as this role in on site in ... outside Central Ohio will not be considered.** **Reports to:** Regional Director of Operations **Organization:** Trinity Health at Home **Key Responsibilities** +… more