Director of health education full time jobs

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered. The National Accounts Medical Director is responsible for serving as the Operational Medical Director for our care management models for our National Account clients. The medical director will be responsible for supporting the clinical vision and implementation to deliver an improvement in the health of the people we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and improving access to the health improvement tools offered to clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance to account reporting regarding use of medical services by members. Involved in identifying and managing medical utilization trends, emerging trends and market changes that impact the client and members. Responsible for proactively identifying and solutioning with account management, Sales RVP Medical Directors. How you will make an impact: * Day to day clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management. * Daily case reviews for both utilization and case management issues. (80/20 split) * Consistent adoption and implementation of all medical policies used for operational reviews. * Leading multidisciplinary rounds for case management /complex clinical management. * Peer-to-peer outreach for both utilization reviews and also for case management consultation with treating providers. * Clinical report reviews, trend management, benefit design consultation, and supporting overall clinical performance guarantee success. * The medical director will be responsible for supporting all state specific requirements that apply for each state where there is our business. Minimum Requirements: * Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). * Must possess an active unrestricted medical license to practice medicine or a health profession. * Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. * Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * For Health Solutions and Carelon organizations (including behavioral health) only, minimum of 5 years of experience providing health care is required. Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency. Preferred Qualifications: * Indiana MD license or compact state multi-licensure is preferred but not exclusive. * Board certification preferably in a Primary Health Specialty, Family or Internal medicine or Surgery (surgical specialty). * Knowledge and experience with population or segment health management is a plus. * Knowledge of the health insurance industry and the National Accounts segment is preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $ 250,236 to $411,102 Locations: Illinois, DC, Nevada. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

**Become a part of our caring community and help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims. The Medical Director, Primary Care work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, participation in care management and possible participation in care facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post-acute care environments. There are discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances, these may require conflict resolution skills. An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market care facilitation and priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. **Required Qualifications** + MD or DO degree. + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification in an approved ABMS Medical Specialty as well as ABQAURP, or other boarddemonstratingadvanced training in transitions of care, quality assurance,utilizationmanagementand care coordination. + A current and unrestricted license in at least onejurisdictionand willing to obtainadditionallicense, ifrequired. + No currentsanctionfrom Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent organizational,verbaland written communication skills. + Evidence of analytic and interpretation skills, with prior experienceparticipatingin teams focusing on transitions of care, quality management,utilizationmanagement, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual. + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanceddegreesuch as an MBA, MHA, MPH + Exposure to value-based care, Public Health, Population Health, analytics, and use of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility toadaptand the courage to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an assigned region, market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. Application Deadline: 12-31-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************

Director of Employer Outreach & Consulting (Administrative Staff) PN 20078541 (250008U6) Organization: Workers' CompensationAgency Contact Name and Information: BWC Human Resources, ********************** Unposting Date: OngoingWork Location: William Green Building 30 West Spring Street Columbus 43215-2256Primary Location: United States of America-OHIO-Franklin County-Columbus Compensation: Based on experience, not to exceed $68.50/HrSchedule: Full-time Work Hours: 8:00 - 5:00Classified Indicator: UnclassifiedUnion: Exempt from Union Primary Job Skill: BusinessTechnical Skills: Insurance, Project Management, Policy DirectionProfessional Skills: Attention to Detail, Decision Making, Organizing and Planning, Verbal Communication, Written Communication Agency OverviewA Little About Us:With roughly 1,500 employees in 7 offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries. Our Culture:BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC employees strive to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee resource groups, participate in online forums discussing society's impact on our services and workplace, and learn about how different perspectives can improve leadership skills. Our Vision:To transform BWC into an agile organization driven by customer success.Our Mission:To deliver consistently excellent experiences for each BWC customer every day.Our Core Values:One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.What our employees have to say:BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.I have worked at several state agencies and BWC is the best place to work.Best place to work in the state and with a sense of family and support.I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.Job DescriptionBWC's core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC's seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.What You'll Be Doing:Manage statewide operations of the Employer Management Service and Employer Outreach & Consulting Programs, including policy and program development, evaluation, and oversight.Serve as a liaison between employers, BWC leadership, stakeholders, and the public to communicate and share critical information.Lead and contribute to short and long term strategic planning efforts aimed at increasing productivity, reducing service costs, and generating premium for the State Insurance Fund.Coordinate program operations across divisions and departments, and establish both annual and long range goals for the agency.Develop and implement policies, procedures, and laws related to underwriting, ensuring staff are trained and compliant.Evaluate and recommend updates to the Ohio Administrative Code to support strategic initiatives and the development of new programs.Represent the division on agency-wide issues, including employer fraud prevention, training seminars, and employer focused programs.Major Worker Characteristics:Knowledge of budgeting, accounting, management, work force planning, employee training & development, supervision, public relation, human relations, BWC policies & Procedures*; counseling; interviewing; business; WC Law*; Federal State tax*. Skill in operating personal computer. Ability to deal with many variables & determine specific action; read & record figures accurately comprehend & record figures accurately, add, subtract, multiply & divide whole number; complete routine forms; maintain accurate records; interview job applicants effectively; understand manual & verbal instructions, technical in nature; prepare meaningful, concise & accurate reports; proofread technical materials, recognize errors & make corrections; use proper research methods in gathering data; gather, collate & classify information about data, people or things; work alone on most tasks; handle sensitive inquiries from & contacts with officials & general public; resolve complaints from angry citizens & government officials. (*) developed after employment Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsPreferred Qualifications:Education Bachelor's degree in a relevant field such as Business Administration, Public Administration, Law, Communications, or a related discipline.Experience5+ years of experience in operations management, strategic planning, and policy development, preferably in a public sector, insurance, or regulatory environment.4+ years of experience coordinating programs, setting organizational goals, and collaborating across departments to achieve strategic objectives.3+ years of experience in stakeholder engagement, public speaking, and representing an organization to external audiences, including advocacy and liaison roles.Skills Proven ability to develop and implement policies and procedures, interpret laws and regulations, and lead cross-functional initiatives.Strong analytical, problem solving, and data analysis skills, with experience using performance metrics to drive decision making.Excellent verbal and written communication skills, with the ability to build relationships with diverse stakeholders and communicate complex information clearly.Demonstrated leadership and supervisory experience, with strong organizational and project management abilities. Unusual Working Conditions:This position is overtime exempt.THIS POSITION IS UNCLASSIFIED PERSUANT TO ORC 124.11(A)(9).Position requires travel; therefore, persons occupying this position must provide their own transportation and/or legally operate a state owned vehicle.The final external applicant selected for this position will be required to submit to urinalysis prior to appointment to test for illegal drug use. An applicant with a positive test result will NOT be offered employment.The final applicant for this position must submit to and pass an extensive background check by the Ohio State Patrol prior to appointment. Supplemental InformationEEO & ADA Statement:The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order.The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request a reasonable accommodation due to disability, pregnancy, or religion, please contact the ADA mailbox at: BWCADA@bwc.ohio.gov.Educational Transcripts:For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed.All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.Background Check:Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

**Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions with external physicians by phone to gather additional clinical information or discuss determinations through the Peer 2 Peer process, and in some instances these may require conflict resolution skills. Other duties include, but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy), and reviews for DME, genetic testing, etc. within their scope. The Medical Director may occasionally speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, state and CMS requirements, Humana policies, clinical standards, and contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of structured and mentored training, daily work is performed with minimal direction, but with ready support from other team members. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient and/or outpatient environment and/or related to care of a Medicaid population (TANF and expansion populations). + Current and ongoing Board Certification in an approved ABMS Medical Specialty + **A current and unrestricted license in KY or willing to obtain by start date. Willingness to obtain additional license(s), as required, but not limited to IN, OH, VA, WI** + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills. + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual + Internal Medicine, Family Practice, Geriatrics, Pediatrics, Hospitalist, Emergency Medicine clinical specialists + Advanced degree such as an MBA, MHA, MPH + Exposure to Public Health, Population Health, analytics, and use of business metrics. + Experience working with the Substance Use Disorder Population. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the KY, OH, VA, WI and IN Medicaid market populations. May provide cross-coverage for other state Medicaid markets. May participate on project teams or organizational committees. All other duties as assigned. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-31-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Reports To: Chief Executive Officer Position Type: Part-Time FLSA Status: Exempt I Am Boundless, Inc. is a mission-driven nonprofit organization that provides lifelong support to individuals with intellectual and developmental disabilities (IDD), autism, and behavioral health challenges. We are committed to delivering high-quality, person-centered care that empowers the people we serve to live lives of meaning, connection, and dignity. Position Summary: The Medical Director / Psychiatrist provides clinical leadership and medical oversight for both residential IDD services and behavioral health programs. This dual role ensures medical and psychiatric care is integrated, evidence-based, trauma-informed, and compliant with all regulatory and ethical standards. The ideal candidate brings deep clinical expertise, a collaborative spirit, and a passion for serving individuals with complex needs in a community-based, nonprofit setting. Key Responsibilities:Leadership & Oversight - Serve as the senior clinical authority for all medical and psychiatric matters affecting individuals in residential, group home, and outpatient behavioral health services. - Develop, review, and update medical and psychiatric policies and protocols in accordance with Ohio Revised Code, DODD Rule 5123-2-02, Medicaid, and CARF standards. - Provide oversight to licensed medical professionals and collaborate closely with nursing, therapy, and direct support teams to ensure continuity and quality of care. Psychiatric Services - Conduct psychiatric evaluations, medication management, and crisis interventions for individuals with IDD and co-occurring mental health or behavioral challenges. - Participate in interdisciplinary treatment planning and collaborate with family members, guardians, and outside providers to promote holistic, person-centered care. - Lead or supervise psychiatric staff and clinical decision-making processes within behavioral health services. Quality, Compliance, & Risk Management - Ensure all medical and psychiatric services are documented accurately and delivered in compliance with state and federal regulations. - Contribute to quality assurance efforts, critical incident reviews, and continuous improvement initiatives across service lines. - Serve as a liaison with external medical providers, hospitals, and regulatory agencies. Education & Consultation - Provide training and consultation to staff on topics such as psychotropic medications, mental health diagnoses, crisis de-escalation, and medical conditions common in IDD populations. - Stay current on emerging best practices and innovations in behavioral health and developmental medicine. Required Qualifications: - Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) with active licensure in the State of Ohio - Board certified or board eligible in Psychiatry; additional certification in Child/Adolescent Psychiatry or Addiction Medicine is a plus - Minimum 3-5 years' experience working with individuals with IDD and/or behavioral health conditions in community-based or residential settings - Strong understanding of person-centered, trauma-informed, and recovery-oriented care models - Familiarity with DODD, Medicaid, and nonprofit healthcare systems - Excellent leadership, communication, and organizational skills Preferred Qualifications: - Prior experience in a Medical Director or supervisory role - Experience working in a nonprofit, managed care, or behavioral health setting - Knowledge of electronic health records (EHR) and integrated care systems Work Environment: - Combination of telehealth, administrative, and in-person visits across residential and outpatient locations in Central Ohio - Flexible schedule with part-time or full-time options, depending on organizational needs and candidate preference - Occasional on-call or crisis consultation availability may be required Compensation & Benefits: - Competitive salary based on experience and role structure (PT/FT) - Comprehensive benefits package including health insurance, dental, vision, PTO, retirement plan, and CME allowance (for full-time roles) - Malpractice insurance provided Join Us: As a vital part of the I Am Boundless leadership team, the Medical Director / Psychiatrist will help shape the future of inclusive, community-based care for individuals with developmental and behavioral health needs. This is more than a job-it's a mission. If you believe in the boundless potential of every person, we invite you to join our team.

Job DescriptionJob Type: Full-time / Part -time We are seeking an experienced and skilled Director of Nursing to lead our home health care team. The successful candidate will be responsible for overseeing the nursing department, ensuring high-quality patient care, and driving clinical excellence. This leadership role requires a strong clinical background, excellent communication skills, and the ability to manage and develop staff. Key Responsibilities: 1. Leadership and Management: - Provide leadership and direction to the nursing staff, including recruitment, training, and development. - Foster a culture of excellence, compassion, and safety. - Manage staffing, scheduling, and budgeting for the nursing department. 2. Clinical Oversight: - Ensure high-quality patient care and outcomes through regular visits, audits, and feedback. - Develop and implement clinical policies, procedures, and guidelines. - Collaborate with physicians, therapists, and other healthcare professionals to ensure comprehensive care. 3. Quality Improvement: - Develop and implement quality improvement initiatives to enhance patient outcomes and satisfaction. - Analyze data and metrics to identify areas for improvement. - Implement evidence-based practices to drive clinical excellence. 4. Regulatory Compliance: - Ensure compliance with regulatory requirements, including OASIS, Medicare, and Medicaid. - Maintain accreditation standards and survey readiness. 5. Staff Development: - Develop and implement staff education and training programs. - Mentor and coach nursing staff to enhance their skills and knowledge. 6. Communication and Collaboration: - Communicate effectively with patients, families, staff, and other stakeholders. - Collaborate with interdisciplinary teams to ensure seamless care transitions. Requirements: - Education: Bachelor's degree in Nursing required; Master's degree preferred. - Licensure: Current RN licensure in the state of practice. - Experience: Minimum 5 years of experience in home health care, with at least 2 years in a leadership role. - Certifications: CPHQ, QIAL, or other relevant certifications preferred. - Skills: - Strong leadership, management, and communication skills. - Ability to analyze data and drive quality improvement initiatives. - Excellent problem-solving and critical thinking skills. What We Offer: - Competitive salary and benefits package. - Opportunity to lead a dynamic team. - Professional development and growth opportunities. If you're a motivated and experienced nursing leader looking for a new challenge, we'd love to hear from you!

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is a remote based (work at home) based anywhere in the US. The Medical Director (Ortho/Total Joint) will be a Subject Matter Expert (SME) with a background in Orthopedic specialty, including post-graduate direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs across the continuum of care. In this role you'll support the Medical Management staff ensuring timely and consistent responses to members and providers. You will lead all aspects of utilization review/quality assurance, directing case management. In this role you will provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities You'll act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams In addition, you will be responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise Required Qualifications* 2 or more years of experience in Health Care Delivery System e. g. , Clinical Practice and Health Care Industry. * Active and current state medical license without encumbrances* M. D. or D. O. ,Board Certification in an Orthopedic specialty including post-graduate direct patient care experience specifically Preferred Qualifications* Previous healthcare insurance experience. Education* M. D. or D. O. ,Board Certification in an Orthopedic specialty. Pay RangeThe typical pay range for this role is:$174,070. 00 - $374,920. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Director of Employer Outreach & Consulting (Administrative Staff) PN 20078541 (250008U6) Organization: Workers' CompensationAgency Contact Name and Information: BWC Human Resources, ********************** Unposting Date: OngoingWork Location: William Green Building 30 West Spring Street Columbus 43215-2256Primary Location: United States of America-OHIO-Franklin County-Columbus Compensation: Based on experience, not to exceed $68.50/HrSchedule: Full-time Work Hours: 8:00 - 5:00Classified Indicator: UnclassifiedUnion: Exempt from Union Primary Job Skill: BusinessTechnical Skills: Insurance, Project Management, Policy DirectionProfessional Skills: Attention to Detail, Decision Making, Organizing and Planning, Verbal Communication, Written Communication Agency OverviewA Little About Us:With roughly 1,500 employees in 7 offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries. Our Culture:BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC employees strive to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee resource groups, participate in online forums discussing society's impact on our services and workplace, and learn about how different perspectives can improve leadership skills. Our Vision:To transform BWC into an agile organization driven by customer success.Our Mission:To deliver consistently excellent experiences for each BWC customer every day.Our Core Values:One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.What our employees have to say:BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.I have worked at several state agencies and BWC is the best place to work.Best place to work in the state and with a sense of family and support.I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.Job DescriptionBWC's core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC's seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.What You'll Be Doing:Manage statewide operations of the Employer Management Service and Employer Outreach & Consulting Programs, including policy and program development, evaluation, and oversight.Serve as a liaison between employers, BWC leadership, stakeholders, and the public to communicate and share critical information.Lead and contribute to short and long term strategic planning efforts aimed at increasing productivity, reducing service costs, and generating premium for the State Insurance Fund.Coordinate program operations across divisions and departments, and establish both annual and long range goals for the agency.Develop and implement policies, procedures, and laws related to underwriting, ensuring staff are trained and compliant.Evaluate and recommend updates to the Ohio Administrative Code to support strategic initiatives and the development of new programs.Represent the division on agency-wide issues, including employer fraud prevention, training seminars, and employer focused programs.Major Worker Characteristics:Knowledge of budgeting, accounting, management, work force planning, employee training & development, supervision, public relation, human relations, BWC policies & Procedures*; counseling; interviewing; business; WC Law*; Federal State tax*. Skill in operating personal computer. Ability to deal with many variables & determine specific action; read & record figures accurately comprehend & record figures accurately, add, subtract, multiply & divide whole number; complete routine forms; maintain accurate records; interview job applicants effectively; understand manual & verbal instructions, technical in nature; prepare meaningful, concise & accurate reports; proofread technical materials, recognize errors & make corrections; use proper research methods in gathering data; gather, collate & classify information about data, people or things; work alone on most tasks; handle sensitive inquiries from & contacts with officials & general public; resolve complaints from angry citizens & government officials. (*) developed after employment Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsPreferred Qualifications:Education Bachelor's degree in a relevant field such as Business Administration, Public Administration, Law, Communications, or a related discipline.Experience5+ years of experience in operations management, strategic planning, and policy development, preferably in a public sector, insurance, or regulatory environment.4+ years of experience coordinating programs, setting organizational goals, and collaborating across departments to achieve strategic objectives.3+ years of experience in stakeholder engagement, public speaking, and representing an organization to external audiences, including advocacy and liaison roles.Skills Proven ability to develop and implement policies and procedures, interpret laws and regulations, and lead cross-functional initiatives.Strong analytical, problem solving, and data analysis skills, with experience using performance metrics to drive decision making.Excellent verbal and written communication skills, with the ability to build relationships with diverse stakeholders and communicate complex information clearly.Demonstrated leadership and supervisory experience, with strong organizational and project management abilities. Unusual Working Conditions:This position is overtime exempt.THIS POSITION IS UNCLASSIFIED PERSUANT TO ORC 124.11(A)(9).Position requires travel; therefore, persons occupying this position must provide their own transportation and/or legally operate a state owned vehicle.The final external applicant selected for this position will be required to submit to urinalysis prior to appointment to test for illegal drug use. An applicant with a positive test result will NOT be offered employment.The final applicant for this position must submit to and pass an extensive background check by the Ohio State Patrol prior to appointment. Supplemental InformationEEO & ADA Statement:The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order.The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request a reasonable accommodation due to disability, pregnancy, or religion, please contact the ADA mailbox at: BWCADA@bwc.ohio.gov.Educational Transcripts:For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed.All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.Background Check:Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and 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, ensuring timely and quality decision making. + 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. + Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, 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. + May be required to work weekends and holidays in support of business operations, as needed. **Education/Experience:** + Medical Doctor or Doctor of Osteopathy. + Utilization Management experience and knowledge of quality accreditation standards preferred. + Actively practices medicine. + Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous. + Experience treating or managing care for a culturally diverse population preferred. **License/Certifications:** + Board certification in general psychiatry or child psychiatry. + 5+ years of experience working in behavioral health managed care or behavioral health clinical settings, with at least 2 years in a clinical setting. + Certification in addiction medicine or in the sub-specialty of addiction psychiatry preferred. + Current OH state license as a MD or DO without restrictions, limitations, or sanctions from government programs. Pay Range: $221,300.00 - $420,500.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Functional Pathways is currently hiring at Otterbein Gahanna SeniorLife in Gahanna, OH, for a full-time Director of Rehabilitation. Licensed Physical Therapist Assistants and Certified Occupational Therapy Assistants are encouraged to apply. * Offering a $10,000 Sign-On Bonus* * Only direct applicants qualify for Bonus* Otterbein Gahanna SeniorLife is a senior living community located in the heart of Gahanna, OH, just minutes away from the Creekside district and Gahanna Woods State Nature Preserve. As a member of the therapy team, you would have the opportunity to work with a team of dedicated healthcare professionals, providing top-quality care to residents in a warm and welcoming environment. With a commitment to person-centered care, Otterbein Gahanna SeniorLife offers a rewarding and fulfilling work experience for those passionate about serving older adults. Why Choose Functional Pathways: At Functional Pathways, we offer a supportive family environment, ethical care, innovation, and a strong focus on values and customer service. Join us in making a positive impact on our residents' lives! Job Summary: The Director of Rehab supports the RM, RVP, and Operations Team to ensure the efficient operation of the facility rehab department. Serving as the liaison between Functional Pathways, the facility, and rehab staff, the Director of Rehab plays a crucial role in coordinating and integrating care. Qualifications * Must have an associate degree from an accredited Physical Therapy Assistant or Occupational Therapy Assistant program. * Must meet all certification and licensure requirements as established by state and national board associations. * Active state license. * Completion of all required screenings, certifications, and licensure. Screening requirements may vary by location. * Two years clinical experience preferred, with experience in geriatric care. * Management experience in the skilled setting, preferred. * Comprehensive leadership skills and ability to supervise. * Excellent organizational and time management skills. * Excellent written and verbal communication skills. * Ability to collaborate with interdisciplinary teams. * Competence in maintaining accurate and timely documentation. * Willingness to engage in ongoing professional development and continuing education activities. #URG1

**Specialty/Competency:** Salesforce **Industry/Sector:** Not Applicable **Time Type:** Full time **Travel Requirements:** Up to 80% At PwC, our people in business application consulting specialise in consulting services for a variety of business applications, helping clients optimise operational efficiency. These individuals analyse client needs, implement software solutions, and provide training and support for seamless integration and utilisation of business applications, enabling clients to achieve their strategic objectives. As a Salesforce consulting generalist at PwC, you will possess a broad range of consulting skills and experience across various Salesforce applications. You will provide consulting services to clients, analysing their needs, implementing software solutions, and offering training and support for effective utilisation of Salesforce applications. Your versatile knowledge will allow you to assist clients in optimising operational efficiency and achieving their strategic objectives. Translating the vision, you set the tone, and inspire others to follow. Your role is crucial in driving business growth, shaping the direction of client engagements, and mentoring the next generation of leaders. You are expected to be a guardian of PwC's reputation, understanding that quality, integrity, inclusion and a commercial mindset are all foundational to our success. You create a healthy working environment while maximising client satisfaction. You cultivate the potential in others and actively team across the PwC Network, understanding tradeoffs, and leveraging our collective strength. Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to: + Lead in line with our values and brand. + Develop new ideas, solutions, and structures; drive thought leadership. + Solve problems by exploring multiple angles and using creativity, encouraging others to do the same. + Balance long-term, short-term, detail-oriented, and big picture thinking. + Make strategic choices and drive change by addressing system-level enablers. + Promote technological advances, creating an environment where people and technology thrive together. + Identify gaps in the market and convert opportunities to success for the Firm. + Adhere to and enforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance) the Firm's code of conduct, and independence requirements. The Opportunity As part of the Salesforce Consulting team you will lead the development and implementation of Salesforce technology-enabled solutions that address client needs. As a Director you will set the strategic direction, drive business growth, and maintain impactful executive-level client relations while mentoring the next generation of leaders. This role requires a visionary approach to problem-solving and the ability to cultivate potential within teams, delivering innovative solutions in a fast-paced environment. Responsibilities - Cultivate innovative problem-solving approaches in a dynamic environment - Deliver solutions that meet client needs - Promote collaboration and knowledge sharing across teams - Uphold the firm's standards of integrity and excellence What You Must Have - Bachelor's Degree - 9 years of experience What Sets You Apart - Preferred field(s) of study: Computer and Information Science or Management Information Systems - One or more Salesforce.com certifications : Certified Administrator, Certified Developer, or Certified Sales/Service/Salesforce Industries (Vlocity) - Demonstrating thought leadership in Salesforce technology solutions - Leading teams to develop client proposals and solutions - Developing and sustaining client relationships through networking - Preparing and presenting thorough and clear presentations effectively - Performing software configuration and coding in Salesforce.com - Leading Salesforce Industry/Vlocity engagements successfully - Working knowledge of Agile and SAFe environments - Experience with implementation in Vlocity / SFI insurance Learn more about how we work: ************************** PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: *********************************** As PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law. For only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all. Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: *************************************** The salary range for this position is: $155,000 - $410,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: *********************************** \#LI-Hybrid

Director of Business Development - Hospice Full Spectrum Search Group is a full-service healthcare recruiting agency specializing in post-acute leadership and healthcare administration. At Full Spectrum, our team of healthcare recruiters is dedicated to bringing exceptional operators and candidates together. We are seeking an experienced Director of Business Development for a regional hospice operator in Ohio with an outstanding industry reputation. This is a full-time, permanent, salaried position with a trusted hospice organization. Our client places employees at the forefront. You can expect a compensation package that includes a lucrative base salary, aggressive bonus structure with achievable quotas, and a comprehensive benefits package. This role is hiring immediately. What makes this position stand out: Strong Operator Reputation: Join a well-established and respected hospice provider with deep roots in the Ohio market. Leadership Stability: Work within an organization known for tenured leadership and a supportive infrastructure. Growth Opportunity: Be part of a growing organization with opportunity to expand market share and influence strategy. Realistic Expectations: Achievable quotas with high earning potential tied to performance. Mission-Driven Culture: Join a team passionate about quality care and community relationships. We would love to connect with you about this job and help you open new doors in your career. Contact us via: Text/Call: ************ LiveChat: ********************* (Business Hours) Email: ********************** Qualifications Proven success in business development or sales leadership in hospice or home health settings. Deep understanding of referral networks, physician relationships, and territory development. Strong knowledge of Medicare regulations and hospice eligibility criteria. Ability to lead by example and drive census growth through relationship-based selling. Exceptional communication, presentation, and networking skills. Reliable transportation and willingness to travel regionally as needed. Responsibilities Develop and execute a strategic sales plan to drive admissions growth across the territory. Build and maintain relationships with physicians, hospitals, case managers, SNFs, and ALFs. Collaborate with clinical and operational leadership to ensure alignment with company goals. Monitor and analyze referral trends, competitor activity, and market dynamics. Provide coaching and mentorship to local liaisons or marketers if applicable. Represent the organization at community events, networking functions, and professional groups. Report progress and metrics to executive leadership regularly. To learn more about this role, connect with us quickly by texting ************, chatting live at *********************, or emailing **********************. With over 29 years of collective experience, Full Spectrum has built management and leadership teams for some of the most prominent operators in the country. As a part of the Starfish Partners Family of Companies, our clients receive the personalized attention of a boutique search firm supported by the resources of the 9th largest executive search firm in the US. Our firm: Is ranked among the Top 10 U.S. & Americas Search Firms. Has been featured in The Wall Street Journal, Fortune, Business Week, and CNN. Has completed over 112,500 searches with a database of 2,540,000 candidates. The solution is here. Come thrive with us! Full Spectrum is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. #IND1

Description “After spending 14 years in healthcare, I finally found my home with Arrow Senior Living. It's home-like environment is not just for the residents but for the team members as well. From day one you embrace the core values, and you see how they impact residents' quality of life. Arrow is a great company to grow with-it promotes within and the employee appreciation, incentives, and benefits are just a bonus on top of making residents and team members smile. I have become lifelong friends with this team, and I can happily say I love my job and enjoy coming to work.”-Arrow Team Member Position- Wellness Director Position Type: Full-TimeLocation: Hilliard, Ohio Our Salary Range: $87,000 - $90,000 Shift Schedule- Monday-Friday, 8am-5pmManager on Duty Weekend Rotation, 10am-2pm Come join our team at Carriage Court of Hilliard located at 3570 Heritage Club Dr. Hilliard, Ohio 43026! We are looking for someone (like you):● Direct and maintain exceptional quality of care for all residents.● Provide oversight, training, motivation, and team building to Wellness staff.● Provide exceptional service to residents, families, and visitors.● Oversee department compliance and budget and ensure Wellness operates according to state guidelines and Arrow policies.● Present a professional demeanor that communicates a corporate philosophy of service, goodwill, and genuine interest, dignity, and respect, celebration, and choice in each resident's needs.● Oversee care companions and medication technicians.● Coordinate medication management.● Ensure outstanding and appropriate care is delivered while adhering to community policy, regulation, and law.● Chart resident notes appropriately.● Review end of shift notes.● Record new/changed physician orders.● Maintain healthcare provider relations.● Perform resident assessments according to established protocol.● Conduct appraisals of resident needs.● Perform other duties as assigned.● Respond to medical emergencies.● Monitor and record physical, mental, and emotional changes observed in residents.● Maintain current and accurate resident charts.● Assist in scheduling medical appointments and maintain a current medical appointment calendar.● Work with the Resident Services Director to implement appropriate activities.● Report regularly to the Executive Director to provide status reports and engage in strategic planning.● Develop and maintain positive working relationships with physicians.● Implement a general staff training program.● In conjunction with the Memory Care Director, implement a dementia specific staff orientation and training program for all employees.● Implement a medication training program.● Train staff using appropriate training materials.● Participate in community surveys.● Meet with families/residents during the admissions process.● Ensure rooms are ready for new residents.● Report any suspicion or evidence of elder abuse, mistreatment or neglect as outlined in Policies and Procedures. What are we looking for?● You must have current Licensed Practical Nurse (LPN) or Registered Nurse (RN) license in good standing within state of employment.● Have at least two years' experience in resident care in assisted living.● Thorough working knowledge of current care standards and regulations.● Experience in hands-on care of memory-impaired residents.● Ability to maintain and update effective service plans.● Ability to supervise care staff.● Comprehensive working knowledge of current medication regulation and law.● Knowledge of requirements for providing care and supervision appropriate to residents.● Ability to communicate with physicians, pharmacies, families, and community staff.● Be in good health, and physically mental and capable of performing assigned tasks. Good physical health shall be verified by a health screening performed by a physician not more than (6) months prior to or (7) days after employment.● Demonstrate freedom from pulmonary tuberculosis within (7) days of employment. ● Must be criminally cleared by DOJ and FBI prior to the initial presence in the facility.● Must have a clean driving record as per the insurance carrier's policy.Employment Benefits (We value our benefits):● Company Match 401(k) with 100% match up to the first 3% and fully vested upon enrollment.● Medical, Dental, Vision insurance (1st of the month following 60 days of employment-Full Time)● Disability insurance (Full Time)● Employee assistance program● Weekly Employee Recognition Program● Life insurance (Full Time)● Paid time off (Full Time employees accrue up to 115 hours each year and Part Time accrue up to 30 hours each year)● Tuition Reimbursement (after 90 days for FT AND PT employees)● Employee Referral Program (FT, PT, and PRN)● Complimentary meal each shift (FT, PT, and PRN)● Daily Pay Option● Direct Deposit● Did we mention that we PROMOTE FROM WITHIN?Do you want to see how much fun we are at Carriage Court Senior Living? Please visit us via Facebook: ************************************************************ Or, take a look at our website: ********************************** Have questions? Want to speak to someone directly? Reach out by calling/texting your own recruiter, Kim Piaggio: ************. Click here to hear about Arrow's Core Values!About the company Arrow Senior Living manages a collection of senior living communities that offer varying levels of care including independent living, assisted living, and memory care in 34 properties currently in 6 states (Missouri, Kansas, Iowa, Illinois, Ohio, Arkansas) and employs nearly 2,200 employees!Arrow Senior Living YouTube-Click Here Arrow Senior Living serves and employs individuals of all faiths, regardless of race, color, gender, sexual orientation, national origin, age, or handicap, except as limited by state and federal law. #OHHPKeywords: hiring immediately, assisted living, nursing home, LPN, Licensed Practical Nurse, wellness, RN, registered nurse, wellness nurse, Manager, Director, ADON, Care Coordinator, Director of Wellness

State Clinical Director (AOD) A Great Opportunity At ViaQuest Psychiatric & Behavioral Solutions we offer unique and individualized care to adults who reside in long term care facilities. Our clients are supported by a team of Certified Nurse Practitioners, Mental Health Nurse, Mental Health Counselors and Social Workers and Therapeutic Behavioral Specialist to ensure the best outcomes for those we serve. Apply today and make a difference in the lives of the clients we serve! Responsibilities may include: Leading the planning, training, supervision, and delivery of comprehensive, integrated behavioral health services encompassing both mental health and alcohol and other drug (AOD) treatment. Managing and supporting a team of mental health clinicians, providing clinical guidance, supervision, and oversight of all client care activities. Conducting comprehensive assessments and providing direct clinical services or client visits as assigned. Ensuring all treatment plans are current, individualized, and aligned with clinical best practices and regulatory standards. Overseeing coordination of care and collaboration with psychiatric providers, internal interdisciplinary teams, and external contracted partners to ensure continuity and quality of behavioral health services. Requirements for this position include: Master's degree in behavioral science or a related field. All licenses must be active and in good standing with the appropriate Ohio licensing board. Ohio LICDC-CS (Licensed Independent Chemical Dependency Counselor - Clinical Supervisor) required. Preferred: Candidates who also hold an LPCC-S, LISW-S or LMFT- S credential Managerial or supervisory experience preferred. Valid driver's license, automobile insurance, and reliable transportation required. Willingness to travel throughout the assigned service area. What ViaQuest can offer you: Comprehensive training. Monthly productivity incentive bonus. Benefit package for full-time employees (including medical, vision, dental, disability and life insurance and 401k). Paid time off. Premium holiday pay. Mileage reimbursement. Flexible scheduling. Employee referral bonus program. About ViaQuest Psychiatric & Behavioral Solutions To learn more about ViaQuest Psychiatric & Behavioral Solutions please visit ****************************************************************** From Our Employees To You ********************************************************** Would you like to refer someone else to this job and earn a bonus? Participate in our referral program! ************************************************************** Do you have questions? Email us at ***********************

Company: OhioHealth at Home At OhioHealth Hospice together with Compassus, we know that caring for our teammates is the first step in caring for our patients. We are committed to providing Care for Who You Are and What You Need to balance work and life including flexible scheduling, a supportive family-focused culture and first-class compensation and benefits. Your position perks as a Hospice Director Clinical Services (Registered Nurse/RN) Supportive and welcoming team Competitive pay and bonus structure Health, dental, vision for part & full-time positions Generous Paid Time Off plan that increases with tenure Wellness reimbursements for physicals and gym memberships Pre-tax FSA and HSA plans (HSA w/company contributions) 401(k) with company matching contributions Free Continuing Education Units Tuition reimbursement Company paid life and long-term disability insurance Company paid parental leave with tenure for birth, adoption, and foster parents Voluntary long-term care, critical illness, and accident insurance Local and national award programs Referral bonus program Mileage reimbursement Corporate discount program w/access to >300,000 businesses Company assistance program supporting teammates in times of need How you'll make an impact as a Hospice Director Clinical Services (Registered Nurse/RN) Supervise patient and family care as specified by the plan of care, assessing appropriateness, continuity, service, and quality of care Support and manage Interdisciplinary Team (IDT) including scheduling, productivity, mentoring and monitoring, 1x1's, pay practices and timekeeping Oversee the consultative process between the Medical Director and the members of the Interdisciplinary Team (IDT) Ensure adherence to the rules and regulations of state and federal regulatory agencies Attend/Lead Interdisciplinary Team (IDT) meetings Process EMR documentation workflow as needed Hospice Director Clinical Services (Registered Nurse/RN) Requirements Registered Nurse with minimum of three years in healthcare required, preferably in Nursing Facility, Home Health or Hospice setting. Bachelor's degree strongly preferred. BSN a plus. Experience in leadership or management strongly preferred. Experience with Electronic Medical Record systems a strong plus. Strong leadership, organizational and interpersonal skills. Hospice Director Clinical Services (Registered Nurse/RN) Certifications, Licenses and Registrations Must be a Registered Nurse licensed in the state of employment. Certification in Hospice and Palliative Nursing a plus but not required. Must have a valid driver's license and auto liability insurance. Care for Who I Am is Caring for Who We Are. Together We Are: Welcoming everyone. Empowering belonging. Allying for inclusivity. Removing barriers. Engaging community. WE ARE fostering an inclusive environment where every teammate matters and can be their best selves. WE ARE becoming a reflection of our patients, families, and partners. WE ARE transforming care at home for every community serve. State Specific Requirements Estimated salary range $53315 - $108487 / year. Actual salary will vary by geographic location and experience. #LI-TC1 Build a Rewarding Career with Compassus At Compassus, we care for our team members as much as we care for our patients and their families. Through our Care for Who I Am culture, we show compassion, respect, and appreciation for every individual. Embark on a career that cares for you while you care for others. Your Career Journey Matters We're dedicated to helping you grow and succeed. Whether you're pursuing leadership roles, specialized training, or exploring new career paths, we provide the tools and support you need to thrive. The Compassus Advantage • Meaningful Work: Make an impact every day by honoring the quality of life of our patients, supporting them and their families with compassion, and creating moments that truly matter. • Career Development: Access leadership pathways, mentorship, and personalized professional development. • Innovation Meets Compassion: Collaborate with a supportive team using the latest tools and technologies to deliver exceptional care. • Enhanced Benefits: Enjoy competitive pay, flexible time off, tuition reimbursement, and wellness programs designed for your well-being. • Recognition and Support: Be celebrated for your contributions through recognition programs that honor your dedication. • A Culture of Belonging: Thrive in a culture where you can be your authentic self, valued for your unique contributions and supported in a community that embraces diversity and inclusion. Ready to Join? At Compassus, your career is more than a job-it's an opportunity to make a lasting impact. Take the next step and join a team that empowers you to grow, innovate, and thrive.

The Clinical Director (CD) provides clinical oversight to ABA services within a center, supports a small caseload and provides ongoing structured mentorship to BCBAs in the center. The CD is integral to the Center Leadership Team, delivering effective, and supportive clinical mentorship and training of BCBAs. The CD has exemplary clinical, leadership, interpersonal and mentorship skills.ResponsibilitiesEssential Functions Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions and other duties. Provides program oversight for a small, patient caseload Conducts behavioral and skills assessments, as required by funding sources, and as needed based on data/clinical judgment Develops compassionate and function-based behavior intervention plans and individualized, developmentally-sensitive treatment plans Completes initial evaluations for potential patients Provides training and supervision to Registered Behavior Technicians (RBTs) and Fieldwork students Completes RBT competency assessments and re-assessments Responsible for continued competence and professional growth for RBTs, Fieldwork Students, and Trainers during weekly consultation (protocol modification) overlaps, by using Behavioral Skills Training Holds regular RBT POD meetings Ensures supervision hours of RBTs meet the requirements of the BACB Builds and maintains positive family/caregiver relationships throughout the lifecycle/course of treatment of the patient Completes regularly scheduled family guidance sessions Identified touchpoints throughout the patient's experience at Hopebridge to meet with the parent/caregiver to review progress and collaborate on individualized treatment plans and behavior plans. Provides regular structured BCBA mentorship sessions and supportive performance guidance Provides clinical oversight, consistent with Hopebridge quality standards and evidence-based practices to BCBAs within center by monitoring clinical program progress through defined quality audit processes Supports clinical performance of BCBAs within center via procedural integrity documentation, provide feedback and necessary training, and communicate concerns to Regional BCBA, Center Manager, and Regional Center Manager as appropriate Implements the Hopebridge BCBA Mentorship and Training curriculum with integrity Act as a liaison to the Regional BCBA for higher level clinical review (i.e., Grand Rounds) and authorization/modifications Supervise and ensure completion of effective, evidence-based individualized treatment plans, behavior support plans and assessments for patients Evaluate clinical performance of BCBAs within center via procedural integrity documentation, provide feedback and necessary training, and communicate concerns to Regional BCBA, Center Manager, and Regional Center Manager as appropriate Provides effective and compassionate center leadership skills Communicates with the Center Manager and acts as a liaison with the center leadership team regarding patient onboarding, clinical structure within the center (i.e., group schedules) Assist the Center Manager with interviewing and onboarding of new BCBAs Ensures that session notes and billing documentation has been submitted through the appropriate systems by specified deadlines In collaboration with the Center Manager, assist in the coordination of daily staffing schedule to ensure patient staffing appropriateness Responsible for tracking and reporting on clinical Key Performance Indicators (KPIs) Consults with Regional team on performance, delivers feedback and seeks guidance on next steps (as appropriate) Uses reports to glean trends in the data and providing action-oriented steps to improve or maintain clinical performance Competencies Attention to Detail - the ability to see and pay attention to details; the ability to recognize the component parts of a procedure or object, and to verify the correctness or error in an individual part or procedure Attitude Toward Others - maintaining a positive, open, and objective attitude toward others Emotional Control - the ability to maintain a rational and objective demeanor when faced with stressful or emotional situations; a measure of self-composure in a difficult situation and the ability to act objectively, rather than impulsively or emotionally Enjoyment of the Job - the feeling that one's job is both fulfilling and rewarding and that it has a positive and useful benefit. Flexibility - the ability to readily modify, respond to, and integrate change with minimal personal resistance Handling Stress - the ability to balance and defuse inner tensions and stresses; the ability to appropriately separate yourself from stressful situations and maintain your own sense of inner peace. Developing Others - develops the ability of others to perform and contribute to the organization by providing ongoing feedback and by providing opportunities to learn through formal and informal methods Communication - excellent written and oral communication skills Self-Awareness and Leadership - demonstrated awareness of personal leadership skills and relationship management Supervisory Responsibility Provides supervision, guidance, and mentorship to BCBAs and BCaBAs within assigned center in accordance with the organization's policies and applicable laws. Provide feedback and supervision to RBTs and Fieldwork students, ensuring clinical competence and demonstrated performance of employees. Position Type/Expected Hours of Work This is a full-time position, Monday through Friday. Occasional evening and weekend work may be required as job duties demand.Required SkillsRequired Education and Experience Master's Degree in Applied Behavior Analysis, Special Education, Psychology or closely related field. Board Certified Behavior Analyst (BCBA) in good standing with the BACB At least three years certification with the BACB as a Board-Certified Behavior Analyst Experience with skills assessments and curricula (e.g., VB-MAPP, ABLLS-R, EFL, AFLS, PEAK), required Substantial experience with behavioral assessments (e.g., Practical Functional Assessments) Strong background in behavior reduction program development and oversight Meets the BACB qualifications to supervise BCaBAs, those pursuing certification, and RBTs Demonstrates ability to supervise as well as transition seamlessly between strategic and hands-on leadership as all as being sought out for superior training techniques Ability to engage and motivate a team toward a common goal Ability to communicate knowledge in the principles of Applied Behavior Analysis (ABA) to professionals and non-professionals Preferred Education and Experience Experience providing supervision to BCBAs Experience with both Medicaid and private-insurance patients preferred Experience with Practical Functional Assessment and Skill-based treatment Experience with Organizational Behavior Management (OBM) Other Duties and Job Requirements Maintain a negative Tuberculosis screening according to the CDC Obtain and possess and maintain current CPR/First Aid certification and re-certification every 2 years Remains current regarding new research, current trends and developments related to autism, special education, and related fields. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Physical Demands: This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. Employees in this position must be physically able to efficiently perform the essential functions of the position. May need to lift pediatric population at times (up to 50 lbs). Work Environment: Work is performed in an office and clinical environment. Work may be stressful at times due to a busy office or center environment with patients. Interaction with others is constant and interrupting. Disclaimer The above statements reflect general functions of this job and shall not be construed as a detailed description of all work requirements inherent in this job. The immediate supervisor may elaborate on or add to the above list if the duties come within the employee's realm of responsibility. Hopebridge is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, arrest record or any other characteristic protected by applicable federal, state or local laws.

Join an award winning, physician-led health system that prides itself on an inclusive, collegial and innovative culture. As Medical Director of Risk Management at OhioHealth, you will receive the support needed to balance your personal and professional goals and impact our mission of improving the health of those we serve. Description: Seeking an experienced physician to lead system-wide risk management initiatives as full time Medical Director Demonstrates expertise in clinical documentation and medical chart review Serves as a key liaison to medical staff and patients Trusted clinical advisor to risk management department, supporting decision making and risk mitigation Oversees patient grievance procedures Generous Benefits package inclusive of time away pay, CME, and wellness offerings to support work life balance Requirements: MD or DO with at least five years of clinical experience Contact information: For questions or to schedule an exploratory call, please contact our Physician Recruiter, Kelsey Beaver. Text: ************ Email: **************************** OhioHealth: Based in Columbus, Ohio,?OhioHealth is a nationally recognized, not-for-profit, charitable, healthcare outreach of the United?Methodist Church.? Serving its communities since 1891, OhioHealth is a family of?35,000 associates, physicians and volunteers, and a network of 16 hospitals, three joint-venture hospitals, one managed-affiliate hospital,?200+ ambulatory sites and other health services spanning a 50-county area.? We are an inclusive organization that prides ourselves on having a world class culture. As a world class organization, we have been recognized as a: 2021 DiversityInc Top Health System Fortune Magazine's 100 Best Companies to Work For 15 times since 2007 Top 10% of Press Ganey's Hospital Experience Survey Complete list of Awards and Recognition: ******************************************

**Become a part of our caring community and help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims. The Medical Director, Primary Care work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, participation in care management and possible participation in care facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post-acute care environments. There are discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances, these may require conflict resolution skills. An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market care facilitation and priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. **Required Qualifications** + MD or DO degree. + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification in an approved ABMS Medical Specialty as well as ABQAURP, or other boarddemonstratingadvanced training in transitions of care, quality assurance,utilizationmanagementand care coordination. + A current and unrestricted license in at least onejurisdictionand willing to obtainadditionallicense, ifrequired. + No currentsanctionfrom Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent organizational,verbaland written communication skills. + Evidence of analytic and interpretation skills, with prior experienceparticipatingin teams focusing on transitions of care, quality management,utilizationmanagement, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual. + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanceddegreesuch as an MBA, MHA, MPH + Exposure to value-based care, Public Health, Population Health, analytics, and use of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility toadaptand the courage to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an assigned region, market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-31-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************

Apply Now Why You'll Love This Job The Clinical Director (CD) provides clinical oversight to ABA services within a center, supports a small caseload and provides ongoing structured mentorship to BCBAs in the center. The CD is integral to the Center Leadership Team, delivering effective, and supportive clinical mentorship and training of BCBAs. The CD has exemplary clinical, leadership, interpersonal and mentorship skills. Responsibilities Essential Functions Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions and other duties. * Provides program oversight for a small, patient caseload Conducts behavioral and skills assessments, as required by funding sources, and as needed based on data/clinical judgment * Develops compassionate and function-based behavior intervention plans and individualized, developmentally-sensitive treatment plans * Completes initial evaluations for potential patients * Provides training and supervision to Registered Behavior Technicians (RBTs) and Fieldwork students * Completes RBT competency assessments and re-assessments * Responsible for continued competence and professional growth for RBTs, Fieldwork Students, and Trainers during weekly consultation (protocol modification) overlaps, by using Behavioral Skills Training * Holds regular RBT POD meetings * Ensures supervision hours of RBTs meet the requirements of the BACB * Builds and maintains positive family/caregiver relationships throughout the lifecycle/course of treatment of the patient * Completes regularly scheduled family guidance sessions * Identified touchpoints throughout the patient's experience at Hopebridge to meet with the parent/caregiver to review progress and collaborate on individualized treatment plans and behavior plans. * Provides regular structured BCBA mentorship sessions and supportive performance guidance * Provides clinical oversight, consistent with Hopebridge quality standards and evidence-based practices to BCBAs within center by monitoring clinical program progress through defined quality audit processes * Supports clinical performance of BCBAs within center via procedural integrity documentation, provide feedback and necessary training, and communicate concerns to Regional BCBA, Center Manager, and Regional Center Manager as appropriate * Implements the Hopebridge BCBA Mentorship and Training curriculum with integrity * Act as a liaison to the Regional BCBA for higher level clinical review (i.e., Grand Rounds) and authorization/modifications * Supervise and ensure completion of effective, evidence-based individualized treatment plans, behavior support plans and assessments for patients * Evaluate clinical performance of BCBAs within center via procedural integrity documentation, provide feedback and necessary training, and communicate concerns to Regional BCBA, Center Manager, and Regional Center Manager as appropriate * Provides effective and compassionate center leadership skills * Communicates with the Center Manager and acts as a liaison with the center leadership team regarding patient onboarding, clinical structure within the center (i.e., group schedules) * Assist the Center Manager with interviewing and onboarding of new BCBAs * Ensures that session notes and billing documentation has been submitted through the appropriate systems by specified deadlines * In collaboration with the Center Manager, assist in the coordination of daily staffing schedule to ensure patient staffing appropriateness * Responsible for tracking and reporting on clinical Key Performance Indicators (KPIs) Consults with Regional team on performance, delivers feedback and seeks guidance on next steps (as appropriate) * Uses reports to glean trends in the data and providing action-oriented steps to improve or maintain clinical performance Competencies * Attention to Detail - the ability to see and pay attention to details; the ability to recognize the component parts of a procedure or object, and to verify the correctness or error in an individual part or procedure * Attitude Toward Others - maintaining a positive, open, and objective attitude toward others * Emotional Control - the ability to maintain a rational and objective demeanor when faced with stressful or emotional situations; a measure of self-composure in a difficult situation and the ability to act objectively, rather than impulsively or emotionally * Enjoyment of the Job - the feeling that one's job is both fulfilling and rewarding and that it has a positive and useful benefit. * Flexibility - the ability to readily modify, respond to, and integrate change with minimal personal resistance * Handling Stress - the ability to balance and defuse inner tensions and stresses; the ability to appropriately separate yourself from stressful situations and maintain your own sense of inner peace. * Developing Others - develops the ability of others to perform and contribute to the organization by providing ongoing feedback and by providing opportunities to learn through formal and informal methods * Communication - excellent written and oral communication skills * Self-Awareness and Leadership - demonstrated awareness of personal leadership skills and relationship management Supervisory Responsibility Provides supervision, guidance, and mentorship to BCBAs and BCaBAs within assigned center in accordance with the organization's policies and applicable laws. Provide feedback and supervision to RBTs and Fieldwork students, ensuring clinical competence and demonstrated performance of employees. Position Type/Expected Hours of Work This is a full-time position, Monday through Friday. Occasional evening and weekend work may be required as job duties demand. Skills & Qualifications Required Education and Experience * Master's Degree in Applied Behavior Analysis, Special Education, Psychology or closely related field. Board Certified Behavior Analyst (BCBA) in good standing with the BACB * At least three years certification with the BACB as a Board-Certified Behavior Analyst * Experience with skills assessments and curricula (e.g., VB-MAPP, ABLLS-R, EFL, AFLS, PEAK), required * Substantial experience with behavioral assessments (e.g., Practical Functional Assessments) * Strong background in behavior reduction program development and oversight * Meets the BACB qualifications to supervise BCaBAs, those pursuing certification, and RBTs * Demonstrates ability to supervise as well as transition seamlessly between strategic and hands-on leadership as all as being sought out for superior training techniques * Ability to engage and motivate a team toward a common goal * Ability to communicate knowledge in the principles of Applied Behavior Analysis (ABA) to professionals and non-professionals Preferred Education and Experience * Experience providing supervision to BCBAs * Experience with both Medicaid and private-insurance patients preferred * Experience with Practical Functional Assessment and Skill-based treatment * Experience with Organizational Behavior Management (OBM) Other Duties and Job Requirements * Maintain a negative Tuberculosis screening according to the CDC * Obtain and possess and maintain current CPR/First Aid certification and re-certification every 2 years * Remains current regarding new research, current trends and developments related to autism, special education, and related fields. * Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Physical Demands: This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. Employees in this position must be physically able to efficiently perform the essential functions of the position. May need to lift pediatric population at times (up to 50 lbs). Work Environment: Work is performed in an office and clinical environment. Work may be stressful at times due to a busy office or center environment with patients. Interaction with others is constant and interrupting. Disclaimer The above statements reflect general functions of this job and shall not be construed as a detailed description of all work requirements inherent in this job. The immediate supervisor may elaborate on or add to the above list if the duties come within the employee's realm of responsibility. Hopebridge is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, arrest record or any other characteristic protected by applicable federal, state or local laws. Apply Now Job Number: 159379 Back to All Jobs