- Molina Healthcare (Covington, KY)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
- Elevance Health (Cincinnati, OH)
- ** Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... employment, unless an accommodation is granted as required by law. The ** Medical Director ** will have program management responsibilities including clinical… more
- Molina Healthcare (Covington, KY)
- …to standardize policies and procedures. + Recruits, hires, trains, mentors, and develops medical director staff and team members as needed. + Ensures ... behavioral health and at least 3 years as a medical director in a managed care setting...management policies across health plans or navigating varied state Medicaid/ Medicare regulations. + Working knowledge of national, state, and… more
- Molina Healthcare (Covington, KY)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the… more
- Bausch + Lomb (Cincinnati, OH)
- …**Overview** Through depth and breadth of customer and industry knowledge, the ** Director , National Accounts** will be responsible for aiding in the development of ... these programs it is also the expectation that the National Account Director will take responsibility for communication, facilitation and implementation with these… more
- ChenMed (Cincinnati, 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
- Danaher Corporation (Cincinnati, OH)
- …engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value and Access team. ... + Communicate regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through internal meetings, payer research, and… more
- Gentiva (Cincinnati, OH)
- …Care Manager to join our hospice team. Reporting directly to the Executive Director or Administrator, you will oversee patient care activities to ensure the delivery ... based on clinical judgment and priority + T riage incoming phone referrals and medical concerns in a timely, compassionate, and professional manner + L ead or… more
- Veterans Affairs, Veterans Health Administration (Cincinnati, OH)
- Summary The Cincinnati VA Medical Center is seeking a Resident Assessment Instrument (RAI)/ Minimum Data Set (MDS) Registered Nurse (RN) in the Community Living ... (CAAs) that are assigned to nursing, adhering to current Centers for Medicare and Medicaid Services (CMS) and Veterans Health Administration (VHA) timeframes of… more
- Gentiva (Cincinnati, OH)
- …Nurse (LPN) to join our team. Reporting directly to the Administrator or Executive Director , you will play a vital role in delivering hands-on hospice care to ... communication and documentation abilities. + Familiarity with regulatory guidelines including Medicare , Medicaid, CMS, and JCAHO standards. + Ability to work… more