- Elevance Health (Mason, OH)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
- Elevance Health (Mason, OH)
- …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
- Molina Healthcare (Dayton, OH)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... resource management . + Develops and implements a Utilization Management program and action plan, which...activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +… more
- Molina Healthcare (Dayton, OH)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Molina Healthcare (Dayton, OH)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management...**REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3… more
- Molina Healthcare (Dayton, OH)
- …closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and ... and clinical leadership for health plan and/or market specific utilization management and care management ...health portions of state contracts. * Assists behavioral health medical director lead trainers in the development… more
- Elevance Health (Mason, OH)
- …schedule: Monday - Friday. Half day Saturday rotation, once a month.** The ** Medical Director ** is responsible for the administration of behavioral health ... increase effectiveness and quality. + Provides oversight, direction, and guidance to Medical Director Associates. + Works independently with oversight from… more
- Elevance Health (Mason, OH)
- ** Medical Director -PSCCR** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... for employment, unless an accommodation is granted as required by law. The ** Medical Director -PSCCR** is responsible for the administration of physical and/or… more
- Elevance Health (Mason, OH)
- ** Medical Director Associate - CarelonRx** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... dispensing services to drive affordability and improve member outcomes. The ** Medical Director Associate- CarelonRx** supports pharmacy prior authorization… more
- Elevance Health (Mason, OH)
- …Associate Medical Director ** **Carelon Medical Benefits Management ** **Radiology Benefit Management / Utilization Review** **Virtual:** This role ... granted as required by law._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the... Director ** is responsible for supporting the medical management staff ensuring timely and consistent… more
- Elevance Health (Mason, OH)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician...**How you will make an impact:** + Supports the Medical Management staff to ensure timely and… more
- Arrow Electronics (Dayton, OH)
- **Position:** Sales Engineering Director - Cloud, Data/AI **Job Description:** **The start date for this position is estimated to be in January 2026.** Arrow is ... seeking a Sales Engineering Director (SED) to provide strategy, technical direction and business...responsibility to, and tight alignment with, Sales and Supplier/Vendor Management . The SED will have leadership responsibility for the… more
- Cintas (Mason, OH)
- **Requisition Number:** 214365 **Job Description** The Director of Corporate Facilities will be responsible for the facilities strategy and day-to-day operations for ... housekeeping, grounds and construction maintenance. + Assist in the planning and management of capital renewal and replacement planning as they relate to the… more
- Molina Healthcare (Dayton, OH)
- …with operational management to identify saving opportunities and areas of medical utilization concerns. + Provide support to financial closing process ... early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies...+ Research and develop reports and analysis for senior management , effectively presenting and communicating results. + Works closely… more
- Molina Healthcare (Dayton, OH)
- …+ Manage projects spanning multiple domains + Supports Market and Enterprise management and other team members are related to all things financially related ... reserves for appropriateness monthly + Work collaboratively with Actuarial and Medical Economics partners to evaluate correlation among various parameters impacting… more
- Elevance Health (Mason, OH)
- …Skills and Experiences:** + ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review experience is preferred. + ... ** Medical Management Nurse** **Location: Virtual: This...whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear… more
- Molina Healthcare (Dayton, OH)
- …need. * Offers a positive leadership role in key segment/product medical management initiatives aimed a optimizing utilization of medical resources. * ... and at least 2 years as a medical director in managed care organization supporting utilization management /quality program management , or equivalent… more
- Fresenius Medical Center (Dayton, OH)
- …and acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization ... during and post procedure, under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse, utilizing standard nursing techniques to… more
- Veterans Affairs, Veterans Health Administration (Dayton, OH)
- …development, and implementation of the project component. Participates in quality management activities of the Medical Center. Responsible for directing ... related services and specialized, evidence-based interventions including assessment, case management , psychotherapy, medication management , and education. Adheres… more
- Veterans Affairs, Veterans Health Administration (Dayton, OH)
- …planning, development, and implementation of the project component. Participates in quality management activities of the Medical Center and/or research projects ... related services and specialized, evidence-based interventions including assessment, case management , psychotherapy, medication management , and education for… more