• Staffing Solutions Organization (Columbus, OH)
    …diverse workforce, which is a reflection of our clients and the people they serve. ** Onsite Reviewer (OH Department of Medicaid ) in Ohio** **(Location - ... overarching responsibility for this position is to ensure Ohio Medicaid providers are providing a legitimate service,...a comprehensive checklist approved by the Ohio Department of Medicaid (ODM). The Onsite Reviewer more
    DirectEmployers Association (08/15/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Columbus, OH)
    **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact… more
    Evolent (07/30/25)
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  • Field Medical Director, Cardiology

    Evolent (Columbus, OH)
    **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet...medical necessity guidelines, as well as other requests when providers , clients, or state laws require specialty reviews to… more
    Evolent (10/01/25)
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  • Field Medical Director- (MD/DO)

    Evolent (Columbus, OH)
    **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet...necessity guidelines, as well as other imaging requests when providers , clients, or state laws require specialty reviews to… more
    Evolent (09/26/25)
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  • Field Medical Director, Oncology

    Evolent (Columbus, OH)
    **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially...necessity guidelines, as well as other imaging requests when providers , clients, or state laws require specialty reviews to… more
    Evolent (08/19/25)
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  • Pharmacy Coordinator

    Highmark Health (Columbus, OH)
    …and report improper coordination of benefit billing practices through paid clams review . + Participate as pharmacy representative in onsite member appeals ... and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal… more
    Highmark Health (10/16/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Columbus, OH)
    …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
    Elevance Health (10/11/25)
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