• Claims Leader, Property & Casualty

    HUB International (Columbus, OH)
    **POSITION SUMMARY:** Overmyer Hall Associates is seeking to add a Claims Leader to their Property & Casualty Service team! The Claims Leader will oversee and ... manage the claims process and claims service team for the region, who are primarily...in our Columbus office, and will report to the Director of Property & Casualty Operations. **ABOUT HUB INTERNATIONAL:**… more
    HUB International (05/30/25)
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  • Managed Care Claims Validator / Biller

    CommuniCare Health Services Corporate (Akron, OH)
    …posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management , and others. The CBO claims validation staff will strive to always ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...of benefit options from life and disability plans to medical , dental, and vision coverage from quality benefit carriers.… more
    CommuniCare Health Services Corporate (05/29/25)
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  • Medical Director - Medicaid N.…

    Humana (Columbus, OH)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (05/14/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - National Medicare

    Humana (Columbus, OH)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (05/29/25)
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  • Medical Director - Care Plus…

    Humana (Columbus, OH)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (04/24/25)
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  • Medical Director , Medical

    J&J Family of Companies (Cincinnati, OH)
    …Learn more at https://www.jnj.com/medtech Johnson and Johnson Family is recruiting a ** Medical Director , Medical Affairs, Johnson & Johnson MedTech** ... also provide strong input on long-term product opportunities and portfolio strategies. The Medical Director will work closely with the Clinical Research team to… more
    J&J Family of Companies (05/22/25)
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  • Director , Field Reimbursement…

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    Director of Field Reimbursement Management (FRM) Position Overview We are seeking an experienced, transformative leader to serve as the Director of Field ... within the assigned region Key Competencies + Strategic leadership and team management + Patient-centric approach to healthcare delivery + Operational excellence and… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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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 ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +...claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees… more
    Molina Healthcare (04/09/25)
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  • Corporate Medical Director

    Humana (Columbus, OH)
    …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (04/24/25)
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  • Director , Global Clinical Development

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Experience with the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Director , TPA & Dental Service Operations

    Medical Mutual of Ohio (Brooklyn, OH)
    …managing and coordinating various operational functions and systems, including claims processing, customer care, membership management , benefits administration, ... overseeing all activities related to the third-party administration of self-funded medical , dental, and specialty benefits. Additionally, the Director more
    Medical Mutual of Ohio (05/03/25)
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  • Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Complete understanding of… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Medicare…

    Humana (Columbus, OH)
    …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (05/14/25)
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  • Product Management Director

    Elevance Health (Mason, OH)
    **Product Management Director - Provider Workflow & Quality Solutions** **Location:** Alternate locations may be considered. This position will work a hybrid ... life through home-care and community based services. The **Product Management Director ** will lead our Provider Workflow...with FHIR, HL7, or X12 standards for clinical and claims data preferred. + Experience working with provider groups,… more
    Elevance Health (05/22/25)
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  • Associate Director , Channel Strategy…

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    **Associate Director , Channel Strategy and Patient Affordability** The Associate Director , Channel Strategy and Patient Affordability reports to the Executive ... Director , Channel Strategy and Patient Affordability. The Associate ...business review development experience + Experience working in matrix management structure with project management , coordination and… more
    Otsuka America Pharmaceutical Inc. (05/29/25)
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  • Sr Director , Performance Suite Analytics

    Evolent (Columbus, OH)
    …health outcomes and a more connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected for this role will be part ... and its customers in the Performance Suite where Evolent does not pay claims + Establish ideal data transfer protocols during client onboarding and implementation,… more
    Evolent (05/02/25)
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  • Director , Specialty Pharmacy Operations

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …Specialty Pharmacy operations for OAPI The position will report to the Executive Director , Channel Strategy and Patient Affordability We are seeking a highly skilled ... and motivated Director of Specialty Pharmacy Operations to lead and oversee...with cross-functional teams, including Brand Marketing, Sales, Patient Access, Medical Affairs, and Regulatory, to integrate pharmacy operations seamlessly… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Associate Director , Established Brands…

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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