Columbus, OH · On-site
$215K - $344K/yr
Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Need 3-5 or more years in practice experience, prefer 2-4 years in FT/PT medical director or ...
Columbus, OH · On-site
$215K - $344K/yr
Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Need 3-5 or more years in practice experience, prefer 2-4 years in FT/PT medical director or ...
Work at Home Part time JR-916742 Your Future Evolves Here Evolent partners with health plans and ... Cardiovascular Utilization Management Reviewer (Electrophysiology) Are you ready to make a ...
Work at Home Part time JR-916742 Your Future Evolves Here Evolent partners with health plans and ... Cardiovascular Utilization Management Reviewer (Electrophysiology) Are you ready to make a ...
Dublin, OH · On-site
$56K - $76K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Dublin, OH · On-site
$56K - $76K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Dublin, OH · On-site
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Dublin, OH · On-site
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Dublin, OH · On-site
$56K - $76K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Dublin, OH · On-site
$56K - $76K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Collaborate with the interdisciplinary team including physicians, utilization review, and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Collaborate with the interdisciplinary team including physicians, utilization review, and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Collaborate with the interdisciplinary team including physicians, utilization review, and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Collaborate with the interdisciplinary team including physicians, utilization review, and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
$1.5K - $2.0K/wk
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
$1.5K - $2.0K/wk
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Dublin, OH · On-site
$56K - $76K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Dublin, OH · On-site
$56K - $76K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Columbus, OH · On-site
$54.50 - $65.25/hr
... utilization reviews. * Provide consultations to patients to ensure their understanding of therapeutic regimens and specifics of administration, potential side effects, allergic precautions, etc.
Columbus, OH · On-site
$54.50 - $65.25/hr
... utilization reviews. * Provide consultations to patients to ensure their understanding of therapeutic regimens and specifics of administration, potential side effects, allergic precautions, etc.
Columbus, OH · On-site
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
Columbus, OH · On-site
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
Columbus, OH · On-site
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
Quick apply
Columbus, OH · On-site
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
Columbus, OH · On-site
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
Columbus, OH · On-site
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
$51.12 - $63.91/hr
Perform Drug Utilization Reviews: Review prescribed medications for safety, efficacy, and appropriateness based on patient history and current medications. * Collaborate with Healthcare Providers:
Bremen, OH · On-site
... part-time employees and their families. • Generous paid time off that accrues over time. • ... including Utilization Review and Discharge Planning experience. • May be required to work ...
Bremen, OH · On-site
... part-time employees and their families. • Generous paid time off that accrues over time. • ... including Utilization Review and Discharge Planning experience. • May be required to work ...
Logan, OH · On-site
... part-time employees and their families. • Generous paid time off that accrues over time. • ... including Utilization Review and Discharge Planning experience. • May be required to work ...
Logan, OH · On-site
... part-time employees and their families. • Generous paid time off that accrues over time. • ... including Utilization Review and Discharge Planning experience. • May be required to work ...
Attends Utilization Reviews and reports as necessary. * Manages Medical Necessity Denials. * May ... Clinical license required (PT, OT, SLP, or RN ). Required Knowledge, Skills, and Abilities
Attends Utilization Reviews and reports as necessary. * Manages Medical Necessity Denials. * May ... Clinical license required (PT, OT, SLP, or RN ). Required Knowledge, Skills, and Abilities
Attends Utilization Reviews and reports as necessary. * Manages Medical Necessity Denials. * May ... Clinical license required (PT, OT, SLP, or RN ). Required Knowledge, Skills, and Abilities
Attends Utilization Reviews and reports as necessary. * Manages Medical Necessity Denials. * May ... Clinical license required (PT, OT, SLP, or RN ). Required Knowledge, Skills, and Abilities
Columbus, OH · On-site
$54.50 - $65.50/hr
... supporting P&T; Committee decisions. This role offers strong intellectual challenge and often ... Evaluate and review new drug products for formulary inclusion or exclusion. * Analyze clinical ...
Columbus, OH · On-site
$54.50 - $65.50/hr
... supporting P&T; Committee decisions. This role offers strong intellectual challenge and often ... Evaluate and review new drug products for formulary inclusion or exclusion. * Analyze clinical ...
Columbus, OH · On-site
$16.25 - $20/hr
Employment Type: Part time Shift: Rotating Shift Description: Are you a pharmacy student eager to ... reviews, renal dosing, medication utilization reviews, patient rounds with physicians ...
Columbus, OH · On-site
$16.25 - $20/hr
Employment Type: Part time Shift: Rotating Shift Description: Are you a pharmacy student eager to ... reviews, renal dosing, medication utilization reviews, patient rounds with physicians ...
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
Cities with the most Part Time Cigna Utilization Review job openings:
States with the most job openings for Part Time Cigna Utilization Review jobs include:
The most popular types of Cigna Utilization Review jobs are:
Columbus, OH • On-site
$215K - $344K/yr
Full-time, Part-time
Re-posted 25 days ago
55-233 Physician / Family Practice: Medical Director / Columbus, OH sm
55-233 Physician / Family Practice: Medical Director / Columbus, OH
Allied Specialty -
State Ohio
Physican Speciality Pediatrics: Medical Director
Sub Specialty -
Position Type Permanent
Recruiter 258
Internal ID JJJ9
Description
Physician / Family Practice: Medical Director / Columbus, OH
Assist the Chief Medical Director to direct & coordinate the medical management, quality improvement and credentialing functions for the business unit.
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for capitated providers.
Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Oversees the activities of physician advisors. Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies.
Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
Develops alliances with the provider community through the development and implementation of the medical management programs. As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues. Represents the business unit at appropriate state committees and other ad hoc committees.
Participating and chairing committees, meeting with provider groups, help developing policies.
Education/Experience:
Medical Doctor or Doctor of Osteopathy, board certified preferable in a primary care specialty (Internal Medicine, Family Practice, Pediatrics or Emergency Medicine).
The candidate must be an actively practicing physician.
Need 3-5 or more years in practice experience, prefer 2-4 years in FT/PT medical director or associate medical director positions.
Previous experience within a managed care organization is preferred.
Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred.
Experience treating or managing care for a culturally diverse population preferred.
License/Certifications:
Board Certification through American Board Medical Specialties.
Current state medical license without restrictions.
Salary:
$215,400 - $344,700
Community:
Columbus, Ohio.
