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Operations Director | Government Liaison - Health Plan Open due to promotion, this multi-faceted role will interface with external and internal stakeholders to maximize outcomes, quality, and profitability for national health insurer. Exceptional boss - strong growth potential. Director is responsible for the oversight of the many moving parts of enrollment, claims, and all other essential administrative components, with a focus on continuous improvement of operational efficiency as well as....

- Columbus, Toledo, Akron, OH

Medical Director- Health Plan - OHIO Physicians seeking a purposeful career will appreciate the opportunity to guide and direct the care for the medically underserved population in OH as part of this expanding market. This national organization welcomes your innovative ideas and solutions for closing the gaps in care and quality. Physicians are encouraged to be actively engaged with their patient population and their physician peers in the community. Incredible opportunities for career....


...VP Health Services | Medical Management (RN) - KANSAS Exceptional analytic support – unlimited career growth .....Reporting to the CEO, experienced clinical leader will establish the strategic vision and drive initiatives around programs of care management and quality. Collaborative participation with the exceptional leadership team in this market is a strong platform for success. Established business and new product are rolling out in KS. Direct and coordinate activities of department and....


...MEDICAL DIRECTOR- LTC and Medicare - FLORIDA! ..........National health plan is growing and diversifying in the FLORIDA market. A physician seeking a purposeful career with an opportunity to make a difference in the quality of care and access to care will thrive in this role. - Medical Director will collaborate with the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the FL health plan. Provides medical leadership....

- Atlanta, GA

MEDICAL DIRECTOR – MCO - Atlanta, GA Physician looking for a purposeful career will enjoy this chance to make a difference in care for the under served population. Great opportunity to influence programs of care and quality. This plan has EXCEPTIONAL leadership and has been a strong performer with consistent growth. · Provides medical leadership for utilization management activities and medical review activities pertaining to utilization review, quality assurance, medical review of complex,....


Sr Director, Provider Contracting – Columbus, OHIO Great manager – highly motivated team –relocation offered. Growing health plan needs a strong communicator with a deep knowledge of value- based contracting and proven ability to build relationships with providers and senior leadership. Drive the development and implementation of network contracting and network development. · Direct the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between


Director, Claims | Contract Support Services – Columbus, OH Positive, collaborative culture and an exceptional mentor make this a very attractive opportunity in OHIO. Unlimited career potential here- and our client will provide you with an excellent relocation package. Direct the strategic analysis and accuracy of claims processes and oversee and ensure compliance with state regulations and/or provider contracts · Oversee the collection, validation and analysis of data to deliver business....

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