- Elevance Health (Independence, 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
- Molina Healthcare (Akron, 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
- 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
- Molina Healthcare (Akron, 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
- 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...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- Molina Healthcare (Akron, OH)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- Molina Healthcare (Akron, OH)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- Cleveland Clinic (Cleveland, OH)
- …with one of the most respected healthcare organizations in the world. The Director of Billing Compliance plays a crucial role in supporting the organization's ... with a strong commitment to excellence. The ideal candidate for Cleveland Clinic's Director of Billing Compliance should possess a blend of technical expertise in… more
- ChenMed (Cleveland, OH)
- …housing managers, senior centers and related community providers to keep ChenMed/JenCare Medical Centers as their top provider choice for senior healthcare when ... handle additional sustained monthly production, developing better working relationships with Center Director , Director of Growth and other market leaders and… more
- Help at Home (Cleveland, OH)
- …of an assigned branch(es) or service area under the supervision of the Director of Clinical Services + Overseeing clinical operations in accordance with agency ... policy and procedure which meet Medicare , Medicaid, accrediting body, local, state, and federal law,...for the Clinical Coordinator when absent + Act as Director of Clinical Services in his/her absence + Will… more
- Gentiva (Akron, 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
- Molina Healthcare (Akron, 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 (Maple Heights, OH)
- …+ Implements strategic planning for referral coordination that contributes to medical cost reduction and improves organizational performance. + Interviews Referral ... to improve referral outcomes. + Participates in executive team and Network Director meetings to collaborate for referral improvements and solutions. + Travels to… more