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19 Jobs

  • Business Analyst- Pharmacy Escalations

    MASON, Ohio
    ... Business Analyst (Bus Info Consultant Sr) _Location: This position will work a hybrid ... investigations into complex issues that may require partnership with IT, Digital, Business, Medical, PBM, and ...

  • Director I Customer Care

    MASON, Ohio
    ... family of companies. We are a third-party administrator (TPA) of medical benefits, also providing medical ... range of services needed by policy owners/clients and filed force to maintain in-force policies or new ...

  • Staff Vice President (VP) Public Relations (Health Benefits)

    MASON, Ohio
    ... and Wisconsin. Our group plans include a variety of group medical, pharmacy, dental, vision, life and ...

  • Medicare Medical Director Clinical Programs

    Mason, Ohio
    ... .** The Medical Director Clinical Programs is responsible for designing and implementing clinical programs with specific medical condition focus for all lines of business enterprise wide. Analyzes and ...

  • Provider Contract/Cost of Care Consultant Senior

    Mason, Ohio
    ... Provider Contract/Cost of Care Consultant Senior-Analytics Location: This ... looking for a senior analyst who will lead medical cost trend deep dives to uncover root-cause trend ...

  • Group Underwriter Consultant, Sr

    Mason, Ohio
    ... Group Underwriter Consultant, Sr Location: Open to any Pulse Point location ... . The Group Underwriter Consultant, Sr is responsible for determining acceptability of ...

  • Reviewer - Therapy Services

    MASON, Ohio
    ... ** is responsible for the review of medical records to determine if requests for therapy services ... additional data, consults with clinical reviewers and medical directors, when necessary. Acts as a ...

  • Provider Operations Manager- AmeriBen

    MASON, Ohio
    ... companies. We are a third-party administrator (TPA) of medical benefits, also providing medical management ...

  • Associate Medical Director - Neurosurgery

    Mason, Ohio
    ... Clinical Operations Associate Medical Director Neurosurgery Carelon Insights/Carelon Medical Benefits Management _A proud member of the Elevance Health family of ...

  • UM Medical Director - Orthopedic Surgery

    Mason, Ohio
    ... Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible ...

  • UM Medical Director - Internal Medicine or Family Medicine

    Mason, Ohio
    ... Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible ...

  • Behavioral Health Medical Director - Child & Adolescent Psychiatry

    Mason, Ohio
    ... .** The Behavioral Health Medical Director is responsible for the administration of behavioral health medical services, to ensure the appropriate and most cost effective medical care is received. May ...

  • Nurse Medical Management I-1

    Mason, Ohio
    ... treatment setting by utilizing the applicable medical policy and industry standards accurately interpreting ... appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and ...

  • Stop Loss Group Underwriter Consultant, Sr

    Mason, Ohio
    ... Stop Loss Group Underwriter Consultant, Sr Location: Open to any open-access ... Stop Loss Group Underwriter Consultant, Sr is responsible for determining acceptability ...

  • Medical Director

    Mason, Ohio
    ... . The Medical Director typically has program management responsibilities including clinical policy ... analytics. Medical Director-Internal Medicine Responsible for the administration of physical and ...

  • Group Underwriting Consultant Sr.

    MASON, Ohio
    ... Underwriting Consultant Sr.** is responsible for determining acceptability of insurance risks and ... experience, location, demographics, etc. Determines and provides guidance to medical underwriters ...

  • UM Medical Director - Physical Medicine and Rehabilitation

    Mason, Ohio
    ... miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost ...

  • UM Medical Director - Cardiology

    Mason, Ohio
    ... miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost ...

  • HEDIS Business Information Consultant

    MASON, Ohio
    ... HEDIS Business Information Consultant Location: This position will take part in ... Business Information Consultant** is responsible for serving as an expert in data analysis, reporting ...
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