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  • Patient Care Manager and Dual RN

    Caretenders

    Managed care director job in Dublin, OH

    The Patient Care Manager and RN Dual role involves supervising and coordinating clinical nursing services for home health patients, ensuring individualized and compliant care in collaboration with healthcare teams. This position requires managing patient referrals, clinician assignments, insurance approvals, and continuous patient assessments. The role emphasizes patient-centered care, leadership development, and work-life balance within a home health care setting. We are hiring a Patient Care Manager and RN Dual role with Home Health experience. At Caretenders Home Health, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve-it truly is all about helping people. You can find a home for your career here. As a Patient Care Manager, you can expect: • opportunities to get closer to patients and provide quality support to your patient-facing teams • to be valued and respected by patients and their families • a sense of security, incredible team support, and flexibility for true work-life balance • leadership development opportunities Our Patient Care Manager and RN Dual role might be a great opportunity if you believe in putting the patient at the center of everything. Apply today! . The Home Health Patient Care Manager is responsible for the supervision and coordination of clinical services and provides and directs provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. • Provides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team. • Receives referrals, ensures appropriate clinician assignments, evaluate patient orders, and plot start of care visits. • Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals. • Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders. • Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate. Current RN licensure in state of practice Current CPR certification required Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation Keywords: patient care manager, registered nurse, home health, clinical coordination, nursing care, patient assessments, insurance approvals, healthcare leadership, care plan management, RN licensure
    $51k-93k yearly est. 6d ago
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  • Associate Medical Director

    National Staffing Solutions 4.2company rating

    Managed care director job in Columbus, OH

    Permanent Associate Medical Director Board Certified in Family Medicine / Internal Medicine FQHC Setting What we Offer: Schedule: M- F 8am to 5pm, No Weekends Competitive Pay: $250k to $270k. depends on experience Sign On Bonus: $30,000 Full Benefits Package - Medical, dental, vision, disability & life insurance. 401(k). What the Associate Medical Director will Do: 80% Clinical / 20% Administration Supervise and coach fellow providers in how to provide excellent primary care / urgent care and community care This is a FQHC setting must be comfortable with Community Medicine Partake in leadership meeting and also act as an ambassador to community based organizations, hospitals, and payers Requirements of the Associate Medical Director: 5+ Years clinical experience / Administrative leadership experience needed Must have 2 -3 recent years experience in primary care medicine Active and unrestricted medical or nursing license in the state required Background in working for a clinic or community based inpatient setting a plus Must be ok prescribing opioids
    $250k-270k yearly 4d ago
  • Senior Director, Clinical Operations (TMF & CTMS)

    Summit Therapeutics Sub, Inc.

    Remote managed care director job

    Career Opportunities with Summit Therapeutics Sub, Inc. A great place to work. Careers At Summit Therapeutics Sub, Inc. Current job opportunities are posted here as they become available. Senior Director, Clinical Operations (TMF & CTMS) Location: On-site 4 days per week at our Menlo Park, CA, Princeton, NJ or Miami, FL office. About Summit: Ivonescimab, also known as SMT112, is a novel, potential first-in-class investigational bispecific antibody combining the effects of immunotherapy via a blockade of PD-1 with the anti-angiogenesis effects associated with blocking VEGF into a single molecule. Ivonescimab displays unique cooperative binding to each of its intended targets with multifold higher affinity when in the presence of both PD-1 and VEGF. Summit has begun its clinical development of ivonescimab in non-small cell lung cancer (NSCLC), with three active Phase III trials: HARMONi is a Phase III clinical trial which intends to evaluate ivonescimab combined with chemotherapy compared to placebo plus chemotherapy in patients with EGFR-mutated, locally advanced or metastatic non-squamous NSCLC who have progressed after treatment with a 3rd generation EGFR TKI (e.g., osimertinib). HARMONi-3 is a Phase III clinical trial which is designed to evaluate ivonescimab combined with chemotherapy compared to pembrolizumab combined with chemotherapy in patients with first-line metastatic NSCLC. HARMONi-7 is a Phase III clinical trial which is intended to evaluate ivonescimab monotherapy compared to pembrolizumab monotherapy in patients with first-line metastatic NSCLC whose tumors have high PD-L1 expression. Ivonescimab is an investigational therapy that is not approved by any regulatory authority in Summit's license territories, including the United States and Europe. Ivonescimab was approved for marketing authorization in China in May 2024. Ivonescimab was granted Fast Track designation by the US Food & Drug Administration (FDA) for the HARMONi clinical trial setting. Overview of Role: The Senior Director, Clinical Operations (TMF) is a clinical research drug development expert accountable for leading and optimizing the delivery of our next generation, integrated platform for clinical trial operations and document management systems including the people, process, technology that support these functions. The individual leads transformative initiatives that create effective and efficient processes that meet high compliance standards; collaborating across Development (focus on Clinical Operations); serving as a change manager to implement new systems and practices that support the organization as we continue to grow. The Senior Director, Clinical Operations (TMF) is an effective clinical operations team leader accountable for talent acquisition, development, management, and evaluation of team members in his/her/their group. This includes responsibility for the ‘What' (delivery to performance goals) and the ‘How' (deliver consistent with Summit Therapeutics core values). The individual is also a member of the Clinical Operations extended leadership team and as such supports and influences the direction of the Clinical Operations extended team. The individual collaborates with team members to reinforce and operationalize strategic direction and solutions that support the ability to deliver on commitments to the organization and to patients. Role and Responsibilities: Develop, implement, and oversee the CTMS and TMF systems and related processes Lead the oversite of TMF and CTMS vendors, contractors, and cross-functional teams provide leadership and development to existing TMF employees and lead by example by demonstrating our core values Define, eexecute, and communicate the strategic vision for TMF and CTMS to maximize end user focus and engagement Partner with key internal and external stakeholders to remediate risks and manage emerging issues. Develop proactive approaches to process improvements and enhancements of TMF and CTMS capabilities and standards Provide business level leadership, foster best practices, and mentor and consult on TMF and CTMS across the Development and Operations organizations Lead a team of TMF and CTMs colleagues and ensure their continuous development Develop and maintain effective working relationships with stakeholder functions to achieve Clinical Operations goals Keep current on changes in industry and regulatory standards for GCP requirements and advises on business impact for TMF and CTMS Provide strategic leadership, insight, and guidance as an active member of the Clinical Operations Extended Leadership Team (XLT) Ensure inspection ready TMF and CTMS and provide expert support for audits and inspections Instill a culture of continuous improvement; acts as a change champion and effectively leads change Other key assignments including ad hoc and stretch assignments in support of Clinical Operations and clinical trial execution Travel on assignment (~25%) All other duties as assigned Experience, Education and Specialized Knowledge and Skills: Bachelor's degree (e.g. BA, BS or equivalent) required; preferably in life science; a clinical or advanced degree in a science, health related, or industry related discipline is preferred Minimum of 12+ years of strong experience with a pharmaceutical company and/or CRO with increasing levels of responsibility in Clinical Operations in a global environment (including directing platform support teams and key clinical systems such as TMF, CTMS) preferred A minimum of 5+ years of experience in people management/leadership required Proven line and functional manager experience, able to effectively lead teams including regional (multi-country) and remote-based staff Experience in Phase III execution of clinical trials; Oncology trials preferred Previous regulatory inspection experience preferred Strong comprehensive and current regulatory knowledge, including ICH Good Clinical Practice, regulations and guidelines Significant vendor oversight experience including contracts and budget management preferred The pay range for this role is $230,000-$250,000 annually. Actual compensation packages are based on several factors that are unique to each candidate, including but not limited to skill set, depth of experience, certifications, and specific work location. This may be different in other locations due to differences in the cost of labor. The total compensation package for this position may also include bonus, stock, benefits and/or other applicable variable compensation. Summit does not accept referrals from employment businesses and/or employment agencies in respect of the vacancies posted on this site. All employment businesses/agencies are required to contact Summit's Talent Acquisition team at ********************* to obtain prior written authorization before referring any candidates to Summit. #J-18808-Ljbffr
    $230k-250k yearly 4d ago
  • Director, Medical Affairs (Remote)

    Stryker Corporation 4.7company rating

    Remote managed care director job

    Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You'll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor's degree A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists. The Opportunity Abbott Heart Failure (HF) delivers devices for patients living with heart failure in the areas of hemodynamic monitoring and mechanical circulatory support. Medical affairs of Abbott HF is seeking to hire a director who will join a team of medical specialist dedicated to all medical aspects of safe and effective device heart failure treatment. The director will report to the Chief Medical Officer. The Director of Medical Affairs will provide daily business operations support related to product development and clinical research, product quality, compliance, commercial/marketing activities and customer interactions. The director assists the Chief Medical Officer in being medical representative of Abbott HF to external regulatory agencies and professional societies. What You'll Work On The Medical Director Develops medical opinions, medical platform documents and Health Hazard Assessments. Provides medical input for promotional and commercial activities as requested. Serves as medical representative on Risk Evaluation teams. Assists investigation teams by providing medical input as needed. Responsible for updating medical affairs procedural documents and submitting change requests when needed. Provides medical support for MDR reporting when needed. Provides initial medical input for quality/regulatory customer communications, technical bulletins and quality directives. Engages with direct customer interactions with medical content as needed. Regionally responsible for Investigator Initiated Study and Research Grant programs. Provides input or content to professional education activities. Responsible for engaging in and documenting off-label discussions. Assists the Chief Medical Officer in KOL and professional society engagement. Provides medical input to new product development An MD is strongly preferred for this role, but a PhD in a relevant area would be considered. A minimum of 5 years of clinical experience including in CV medicine would be clinical research, including interpretation and presentation would be expected. Strong presentation skills required. The role is remote (US-based) Up to 70 % travel should be expected. APPLY NOW Enjoy a competitive base salary plus exciting bonus opportunities and long-term incentives designed to recognize your success. Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: ********************** Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity. Connect with us at *************** on Facebook at *********************** and on Twitter @AbbottNews and @AbbottGlobal #J-18808-Ljbffr
    $221k-314k yearly est. 5d ago
  • Bilingual Behavioral Health Care Manager

    Heritage Health Network 3.9company rating

    Remote managed care director job

    This role works closely with Care Team Operations, Clinical Operations, Behavioral Health clinicians (LMFT/LCSW/LPCC), Community Health Workers (CHWs), Compliance, Finance (for authorizations), Care Operations Associates, and external partners including hospitals, primary care providers, behavioral health agencies, housing providers, and community-based organizations. Responsibilities Serve as the primary point of contact for assigned members with behavioral health and psychosocial complexity, building trust through consistent, trauma-informed engagement. Conduct comprehensive, holistic assessments addressing behavioral health, substance use, functional status, social determinants of health, safety risks, and care gaps. Develop, implement, and maintain person-centered care plans that integrate behavioral, medical, and social goals; update plans following transitions of care or changes in condition. Coordinate services across the continuum of care, including behavioral health providers, primary care, hospitals, housing supports, transportation, social services, and community-based organizations. Conduct required in-person home or community visits based on acuity, risk stratification, and payer requirements. Support Transitions of Care (TOCs) by completing timely follow-up, coordinating post-discharge services, and reinforcing discharge instructions and medication understanding. Utilize motivational interviewing, behavioral coaching, and health education to promote engagement, adherence, self-management, and long-term member stability. Identify, escalate, and address behavioral health risks, safety concerns, service delays, benefit lapses, and environmental barriers using HHN escalation protocols. Coordinate and track referrals, appointments, transportation, and follow-ups to ensure continuity and timeliness of care. Maintain accurate, timely, and audit-ready documentation of all assessments, encounters, and interventions in eClinicalWorks (ECW) and other HHN systems. Meet or exceed HHN and health plan productivity standards, including outreach cadence, encounter requirements, documentation timeliness, TOC completion, and quality measures. Actively participate in multidisciplinary case reviews, care conferences, team huddles, and escalations with nurses, behavioral health clinicians, CHWs, care operations, and compliance. Assist members with plan navigation, eligibility redeterminations, social service applications, housing resources, and crisis intervention support. Communicate professionally with members and care partners using HHN-approved channels, including phone, RingCentral, secure messaging, and SMS workflows. Contribute to continuous quality improvement efforts by identifying workflow gaps, documenting barriers, and sharing insights to improve care delivery. Uphold confidentiality and comply with all HIPAA, Medi-Cal, ECM, and payer regulatory requirements. Remain flexible and responsive to member needs, including field-based work and engagement in community settings. Skills Required Bilingual (English/Spanish) proficiency required to support member engagement and care coordination. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field. Licensure: Licensed LMFT, LCSW, LPCC.; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
    $61k-76k yearly est. 14h ago
  • Remote Liver Medical Affairs Director - Regional Expert

    Gilead Sciences, Inc. 4.5company rating

    Remote managed care director job

    A leading biopharmaceutical company is seeking a Senior Director for Medical Affairs to lead initiatives focused on liver diseases. The ideal candidate should have substantial clinical experience in hepatology and a commitment to scientific excellence. This remote position requires strategic collaboration and contributions to research efforts to improve liver care outcomes. Strong leadership and communication skills are essential for engaging diverse healthcare professionals in clinical discussions. #J-18808-Ljbffr
    $235k-330k yearly est. 1d ago
  • Remote Care Manager

    Teksystems 4.4company rating

    Remote managed care director job

    *Care Manager (Remote)* *Start Date : 2/17* *Work Environment:* * Fully remote; must have a quiet workspace and provide a photo of designated area. * Shift: 8:00 AM - 8:00 PM EST (8-hour shift) * Training: 8:30 AM - 5:00 PM EST for 2 weeks Care Managers make high-volume outbound calls to payors/pharmacy benefit managers (PBMs) to verify copay support eligibility for commercially insured patients. This is a phone-intensive role (up to 95% of shift on calls) requiring strict adherence to scripts, accurate documentation, and professional customer service. *Key Responsibilities:* * Make outbound calls to PBMs/payors for copay eligibility; maintain 95% phone engagement. * Follow approved call guides and compliant scripts. * Identify and record plan types (e.g., Traditional, Accumulator, Maximizer). * Use PBM-specific workflows to gather benefit details. * Document all interactions accurately in CRM/telephony tools in real time. * Manage follow-up tasks promptly. * Maintain proper telephony status and campaign selection. * Adhere to compliance, privacy, and quality standards. * Collaborate professionally with PBM contacts and internal teams. *Requirements:* * *Experience:* 1+ year in a call center or high-volume phone environment preferred. * *Skills:* Strong attention to detail, excellent verbal communication, ability to follow scripts and document accurately. * *Technical:* Reliable high-speed internet, computer with webcam, and ability to work in a quiet space (photo required). * *Availability:* Must commit to training schedule and assigned shift. *Job Type & Location* This is a Contract position based out of Houston, TX. *Pay and Benefits*The pay range for this position is $21.00 - $21.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) *Workplace Type*This is a fully remote position. *Application Deadline*This position is anticipated to close on Jan 16, 2026. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
    $21-21 hourly 4d ago
  • Director of Nursing (DON)

    Jag Healthcare 4.3company rating

    Managed care director job in Marion, OH

    JAG Healthcare Marion is now scheduling RN/DON interviews as we are searching for our next long-term Director of Nursing (DON). JAG Healthcare Marion is seeking a strong, energetic Director of Nursing (DON) to work alongside their long-time Administrator to help maintain the excellent care culture that is established there. The Director of Nursing (DON) should be a compassionate RN who has at least five years of experience as a Director of Nursing or in a comparable position. Recognizing that there is much opportunity in our healthcare employment market for potential applicants, we are seeking candidates interested in employment stability, flexible scheduling, and the desire to secure a long-term employment opportunity. Being a smaller facility, there is a balance in the workload and exceptional patient care ratios. Leadership staff are expected to lead by example and be team-oriented to ensure the highest level of quality care and service can be delivered to our residents. JAG Healthcare Marion has only 45 beds, giving it a homelike feel for our residents. This quaint environment also provides our nurses the opportunity to spend meaningful time with their residents without rushing from one room to the next. This is one of the most common positive comments that we hear from nurses coming from larger healthcare facilities. If you are looking for a rewarding job as a Director of Nursing (DON) that allows you to build meaningful connections with residents while improving their quality of life, this job could be for you!. Skills & Responsibilities (include but not limited to): Direct, oversee, coordinate & evaluate nursing care services provided to the residents. Emphasis on education and staff development to grow and develop the nursing team Ensuring compliance with all State & Federal guidelines. Ensuring all confidentiality and privacy rights of residents are observed & enforced. Overseeing State Survey complaints, investigations, and resolutions. Develop and enforce policies aiming for legal compliance and high-quality standards. Develop objectives and long-term goals for the department. Guide staffing procedures. Excellent ability to lead and develop personnel. Willingness for continual education to keep up with changing standards in nursing administration. Exceptional communication and problem-solving skills, with a focus on customer service. Strong focus on Quality Assurance and Performance Improvement Team-oriented with the ability to work in a collaborative interdisciplinary setting Requirements for the position include: Licensed as a Registered Nurse (RN) in the State of Ohio and in good standing with the Board of Nursing. Must be familiar with and be able to follow all established Federal, State and Local rules, regulations, and guidelines. Must understand and be able to implement and follow the facility policy/procedure. Proven ability to lead a clinical team to successful clinical outcomes. Minimum of 5 years DON experience, or comparable position (required) Minimum of 5 years of acute care, long-term care, or geriatric supervisor and management experience in a Medicaid/Medicare certified facility (required). Experience working with cognitive deficits and behavioral health care (plus). Successful completion of the Infection Preventionist Training (preferred, but willing to assist with certification) Strong focus on inventory and supply chain management At JAG Healthcare, we offer a homelike family family-oriented atmosphere, striving to create a lifetime of balance for our residents, employees, and the communities in which we serve .
    $63k-79k yearly est. 5d ago
  • Remote General Radiology - 7 Eves On/7 Eves Off - Medical Imaging Associate

    Radiology Partners 4.3company rating

    Remote managed care director job

    Medical Imaging Associates is seeking a Remote General or Remote Fellowship trained Radiologist who can live anywhere in the U.S.A * Emergency, inpatient, and urgent care imaging with subspecialty opportunities available. * 3 - 11 pm MST * 7 on 7 off or 7 on 14 off options * Primary responsibilities include ER and urgent care, followed by inpatient and outpatient studies. Reading subspecialty outpatient cases is possible when emergent cases are caught up. LOCAL PRACTICE AND COMMUNITY OVERVIEW Medical Imaging Associates (MIA) is the leading regional radiology practice based in Eastern Idaho and provides comprehensive imaging services in ID, WY, MT, and UT. Our practice of over 30 radiologists and APPs provides the full spectrum of inpatient and outpatient radiology, diagnostic and interventional, general and subspecialty, day, and night, on-site and remote. Come join an excellent group of collegial radiologists and support staff! We have a great collaborative work environment and atmosphere. We focus on group unity with monthly group lunches, summer and winter socials, and open communication at work. Additionally, Southeastern Idaho is home to some of the most beautiful landscapes on earth! Pocatello and the surrounding area have countless hiking and biking trails and endless places for camping and enjoying the outdoors. We are located a short drive from Yellowstone National Park, Grand Teton National Park, Sawtooth Mountain Range, Jackson Hole, Bear Lake Idaho, and multiple additional state and national parks. We have some of the best fishing and hunting in the country and endless miles of land for ATV riding, snowmobiling, or other recreation. If you are looking for a great practice and a wonderful place to live, you have found it! DESIRED PROFESSIONAL SKILLS AND EXPERIENCE * General Radiology. Fellowship training is a plus, but not required. * American Board of Radiology (ABR) certified or eligible * American Osteopathic Board of Radiology (AOBR) certified or eligible * Licensed or ability to be licensed in Idaho, Wyoming, Montana, and Utah COMPENSATION: The salary range for this position is $500,000-$700,000. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location etc. This role is also eligible for an annual discretionary bonus. In addition to this range, Radiology Partners offers competitive total rewards packages, which include health & wellness coverage options, 401k benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements). FOR MORE INFORMATION OR TO APPLY For inquiries about this position, please contact Geri Ferguson at ************************** or **************. RADIOLOGY PARTNERS OVERVIEW Radiology Partners, through its affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve. Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system overall. We hold that diversity is a key source of strength from which we will build a practice culture that is inclusive for all. Our goal is to empower and engage the voice of every teammate to promote awareness, compassion and a healthy respect for differences. Radiology Partners participates in E-verify. CCPA Notice: When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History. Beware of Fraudulent Messages: Radiology Partners will never request payment, banking, financial or personal information such as a driver's license in exchange for interviews or as part of the hiring process. Additionally, we will not send checks for deposit into your bank account at any stage of recruitment. All communication during the interview and hiring process should come from an email address ending in "@radpartners.com." If you suspect you are receiving a fraudulent job offer or solicitation from Radiology Partners or one of our local practices, please notify our Recruiting Team at **************************.
    $173k-316k yearly est. 12d ago
  • Per Diem Health Plan UM Medical Director

    Massachusetts Eye and Ear Infirmary 4.4company rating

    Remote managed care director job

    Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan UM Medical Director Qualifications Education: MD or DO required Licenses and Credentials: Physician - Massachusetts active full license required Experience: 5+ years of Health Plan UM experience at least 5 years of clinical practice experience Knowledge, Skills and Abilities: Utilization Management experience Excellent written and oral communications skills Proficient in basic computer skills, use of EHR's, digital tools Multitasking abilities Adaptable to change due to business growth Job Description: Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities Use CMS, state and internal medical necessity policies to guide MN determinations Complete peer to peer case discussions with requesting providers as assigned Refer to IRO/external review if specialist match or expertise is needed Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees Monitors performance metrics to identify areas for continuous improvement and ensure compliance Establishes and maintains positive relationships with colleagues and customers and gains their trust and respect Ensure diversity, equity and inclusion are integrated as a guiding principle Other duties as assigned with or without accommodation Additional Job Details (if applicable) Primarily remote position M-F 830-5pm EST Ensures that all assigned work is completed within regulatory timelines Checks and addresses assigned work queues, email, Teams messages during assigned work hours Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 0 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Balance Sheet Cost Centers is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $206k-287k yearly est. Auto-Apply 9d ago
  • Medical Director, Cardiometabolic Clinical Care Model Design and Client Engagement

    Teladoc Health Medical Group 4.7company rating

    Remote managed care director job

    Join the team leading the next evolution of virtual care. At Teladoc Health, you are empowered to bring your true self to work while helping millions of people live their healthiest lives. Here you will be part of a high-performance culture where colleagues embrace challenges, drive transformative solutions, and create opportunities for growth. Together, we're transforming how better health happens. Summary of Position Teladoc Health is seeking an experienced physician to serve as Medical Director, Cardiometabolic Clinical Care Model Design and Client Engagement. This physician leader will serve in a highly cross-functional role instrumental in shaping the future of cardiometabolic care at Teladoc Health, particularly within our U.S. Group Health Business, advancing clinical excellence across existing chronic condition management solutions while building and scaling novel approaches. This role will continue to champion seamless integration of cardiometabolic care across our expansive ecosystem of virtual primary care, urgent care, mental health, expert medical/specialty care, and more. This is an individual contributor leadership position requiring strong clinical expertise in cardiometabolic care and the ability to work strategically in the complex and rapidly evolving virtual care/digital health space. Success in this role requires close cross-functional collaboration with diverse stakeholders to enhance care delivery models, achieve best-in-class clinical outcomes, and optimize return on investment. The candidate will support value-based care partnerships and drive clinical research to strengthen the evidence base for virtual cardiometabolic care. Additionally, this physician leader must be able to translate these efforts into client-facing strategies, partnering with employers and payers to help them understand and achieve better health outcomes for their populations. Essential Duties and Responsibilities Serve as the clinical lead for designing cardiometabolic care models across new and existing capabilities within the U.S. Group Health business. Lead clinical and cross-functional teams to design, pilot, and scale innovative integrated cardiometabolic care models, working closely with front-line providers and care teams. Translate population health data and risk stratification into actionable program strategies. Define success metrics-including clinical outcomes and financial ROI-and develop strategies for sustained impact. Work closely with internal teams-including sales, marketing, and client-facing groups-providing clinical expertise for key presentations and client discussions. Represent the organization externally on topics related to chronic condition management and cardiometabolic care innovation. Develop and refine chronic condition management frameworks, measures, and reporting aligned with the Institute for Healthcare Improvement Quadruple Aim and Institute of Medicine quality domains: safety, effectiveness, patient-centeredness, efficiency, timeliness, and equity. Co-lead formal quality improvement projects using the Model for Improvement with a focus on process and outcome metrics and leveraging statistical process control (SPC) where appropriate. Partner with our Clinical Research team to generate evidence and insights for white papers and peer-reviewed publications demonstrating the impact of our cardiometabolic solutions. The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs. Supervisory Responsibilities No Required Qualifications MD/DO in Internal Medicine, Family Medicine, or a cardiometabolic specialty; active medical license preferred At least 5+ years of post-residency or fellowship clinical experience Experience in virtual care, digital health, or healthcare technology, with the ability to adapt to rapid change and ambiguity. Demonstrated expertise in delivering evidence-based clinical care model design, clinical quality improvement, outcome measurement. Exemplary written and verbal communication skills, including the ability to explain complex clinical concepts to non-clinical audiences. Proven ability to collaborate effectively across clinical and non-clinical teams, including operations, product, engineering, marketing, commercial, and other functions in a highly matrixed environment. Strong prioritization, time management, and organizational skills, with meticulous attention to detail. Ability to thrive in fast-paced, dynamic environments with multiple competing priorities and deadlines. Preferred Qualifications Experience in dedicated virtual care/digital health organizations focused on cardiometabolic conditions. MBA/MPH and/or advanced quality improvement training preferred. Demonstrated experience delivering virtual care, particularly in primary care and cardiometabolic management beyond the COVID-19 pandemic. Expertise in value-based care delivery with track record of maximizing clinical outcomes while managing total cost of care. Required license or credential needed to perform job: MD/DO The above qualifications, knowledge, experience, and/or background are expected but not required for this role. Work Environment ☐ Office ☒ Remote ☐ Hybrid (Office & Remote) Travel: ≥10% Travel percentage reflects an estimate and is subject to change dependent on business needs. The base salary range for this position is $210,000 - $240,000. In addition to a base salary, this position is eligible for a performance bonus and benefits (subject to eligibility requirements) listed here: Teladoc Health Benefits 2026. Total compensation is based on several factors including, but not limited to, type of position, location, education level, work experience, and certifications. This information is applicable for all full-time positions. As part of our hiring process, we verify identity and credentials, conduct interviews (live or video), and screen for fraud or misrepresentation. Applicants who falsify information will be disqualified. Teladoc Health will not sponsor or transfer employment work visas for this position. Applicants must be currently authorized to work in the United States without the need for visa sponsorship now or in the future. Why join Teladoc Health? Teladoc Health is transforming how better health happens. Learn how when you join us in pursuit of our impactful mission. Chart your career path with meaningful opportunities that empower you to grow, lead, and make a difference. Join a multi-faceted community that celebrates each colleague's unique perspective and is focused on continually improving, each and every day. Contribute to an innovative culture where fresh ideas are valued as we increase access to care in new ways. Enjoy an inclusive benefits program centered around you and your family, with tailored programs that address your unique needs. Explore candidate resources with tips and tricks from Teladoc Health recruiters and learn more about our company culture by exploring #TeamTeladocHealth on LinkedIn. As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status, or pregnancy). In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind. Teladoc Health respects your privacy and is committed to maintaining the confidentiality and security of your personal information. In furtherance of your employment relationship with Teladoc Health, we collect personal information responsibly and in accordance with applicable data privacy laws, including but not limited to, the California Consumer Privacy Act (CCPA). Personal information is defined as: Any information or set of information relating to you, including (a) all information that identifies you or could reasonably be used to identify you, and (b) all information that any applicable law treats as personal information. Teladoc Health's Notice of Privacy Practices for U.S. Employees' Personal information is available at this link .
    $210k-240k yearly Auto-Apply 9d ago
  • Regional Medical Affairs Director - Gulf Coast

    Xeris Pharmaceuticals 4.2company rating

    Remote managed care director job

    The Regional Medical Affairs Director (RMAD) is a member of a field-based team which is an extension of the US Regional Medical Affairs organization and is responsible for developing and enhancing professional relationships with specified key thought-leaders (KTLs), institutions, and organizations in their assigned geographical region. A RMAD focuses on medical & scientific engagement with identified healthcare and decision maker stakeholders by providing medical and scientific support via scientific exchange, addressing customers medical and scientific informational needs, and collaborating in mutually identified areas of medical, education, clinical research, and real-world experience/evidence. RMADs are recognized as an internal subject matter expert and provide appropriate medical and scientific support for internal teams as identified. Candidate to reside in: Houston, TX; San Antonio, TX; New Orleans, LA; or Jackson, MS Territory covers: TX, LA, MS Responsibilities Fostering mutually collaborative relationships with institutions, Centers of Excellence, thought leaders (TLs) and key decision makers across the healthcare ecosystem in the areas of medical, education, clinical research, and real world experience. Provide medical information through scientific exchange in a fair-balanced manner and clinical/scientific support as identified or requested in addressing the informational needs of the healthcare community, as well as responding to unsolicited requests for pipeline or off-label information. Delivering medical presentations to diverse healthcare professional (HCP) audiences including healthcare decision makers, professional medical societies, and identified advocacy groups. Providing scientific and liaison support related to Xeris clinical research activity, including thought leader and investigator engagement and follow-up, and facilitation of unsolicited requests for interactions related to Investigator Initiated Studies (IISs). Maintaining cross-functional collaboration with internal & external field teams to provide scientific expertise and medical support within Medical Affairs, Clinical Development, Commercial, and other internal stakeholders, etc. Obtaining, assimilating, organizing, and reporting appropriate competitive and scientific intelligence in a concise, clear manner, compliant with all applicable Xeris policies, procedures, and processes Attending & participating in medical/scientific meetings and conferences for the purpose of gaining scientific insights, collecting emerging scientific data, identifying healthcare trends, and supporting the scientific exchange and communication related to Xeris therapeutic areas of interest and research & development As identified, contribute to internal training for headquarter- and field-based teams and supporting speaker training initiatives. Assisting with the implementation and engagement of TL participation in advisory boards, consultant meetings and other scientific meetings consistent with all Xeris policies, procedures, and processes. Maintain clinical/scientific expertise and providing strategic insights into emerging scientific data and healthcare trends. Collaborating with TLs and Xeris Medical Communications to support the development of appropriate publications and related medical communications. Participate in assigned Medical Affairs projects, initiatives, and activities as identified and requested. Performing and completing administrative responsibilities, including reporting requirements in a timely fashion Qualifications Advanced degree (MD, PhD, PharmD, DNP) in a related discipline strongly preferred Less than 2 years of experience [Entry level as Associate Director]; 2+ years of experience [Entry Level as Director] of previous Field Medical or Medical Affairs pharmaceutical industry [post-doctoral pharmaceutical industry training via residency or fellowship also welcomed] Active clinical care, clinical research, or academia experience preferred Clear understanding of regional medical practice, clinical decision-making and healthcare systems affecting patient care. Demonstrated strong understanding of clinical research trial and/or related laboratory research design and execution Extensive knowledge of Endocrinology, including Cushing's Disease and field medical affairs is strongly preferred. Competencies: Customer Service focus, Teamwork & Collaboration, Written and Verbal Communication skills, Presentation skills, Time Management skills, Self-Starter. Working Conditions: Position may require periodic evening and weekend work, as necessary to fulfill obligations. Periodic overnight travel. Approximately 60% overnight travel The level of the position will be determined based on the selected candidate's qualifications and experience. #LI-REMOTE As an equal employment opportunity and affirmative action employer, Xeris Pharmaceuticals, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, genetics or any other characteristic protected by law. It is our intention that all qualified applications are given equal opportunity and that selection decisions be based on job-related factors. The anticipated base salary range for this position is $170,000 to $225,000. Final determination of base salary offered will depend on several factors relevant to the position, including but not limited to candidate skills, experience, education, market location, and business need. This role will include eligibility for bonus and equity. The total compensation package will also include additional elements such as multiple paid time off benefits, various health insurance options, retirement benefits and more. Details about these and other offerings will be provided at the time a conditional offer of employment is made. Candidates are always welcome to inquire about our compensation and benefits package during the interview process. NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization. Direct Employers Posting: Houston, TX; New Orleans, LA; Jackson, MS.
    $170k-225k yearly Auto-Apply 5d ago
  • Sales Director, Hospitality (Hotels)

    Azira

    Remote managed care director job

    Location: USA Remote | Job Type: Full-Time | Team: Sales Azira is a location intelligence platform built for today's data-driven teams, transforming mobile location signals into high-confidence, privacy-first insights. Our technology helps marketing, operations, and data leaders make smarter decisions, optimize performance, and drive measurable growth. From retailers and media agencies to destination marketers and real estate teams, we deliver trusted, validated insights rooted in real-world behavior-connecting the dots between where people go and how businesses can better reach, serve, and grow their audiences. Why This Role Matters As Sales Director, Hospitality, you will assist Azira's growth strategy among hotel chains and brands. In this role, you will be a part of the driving force behind expanding Azira's presence and elevating our brand with major hospitality companies and their partner agencies across North America. You will join a stellar sales team, and focus on the hospitality category, specifically branded properties and chains. Your role will be crucial to driving new business growth, and partner cross-functionally to deliver powerful solutions that blend data, insights, and media. This is a high-impact, high-visibility role that's critical to Azira's growth in a strategic vertical. We're looking for someone with a proven track record of driving sales growth with hotel brands and chains. The ideal candidate will have a solid understanding of the evolving trends, relationships and key brand priorities, as well as the broader advertising and marketing technology landscape, including programmatic, social, and CTV. We will prioritize candidates with proven success working with hotel chains, a passion for media and technology, and the drive to elevate the Azira brand to new heights. If this sounds like your world, let's talk! What You'll Do Assist in leading sales execution among chains and brands for the Hotel Vertical, from planning to close Build and manage a strong pipeline of hotel brands and agency partners through proactive outreach, networking, and relationship development Conduct discovery sessions, craft compelling pitches, and tailor proposals to align Azira's capabilities with client goals Close complex, enterprise-level deals and consistently exceed quarterly and annual revenue targets Collaborate with Product, Marketing, and Executive teams to shape category-relevant solutions Represent Azira at key industry events, conferences, and client meetings Share best practices and contribute to the broader Sales team's growth and development What You'll Bring 7+ years of enterprise sales experience and media experience, specifically in the hospitality vertical (required) Deep understanding of media buying on behalf of hotels and their flags (required) Proven success using a consultative sales approach to close complex, high-value deals and grow long-term partnerships in the hotel industry. Excellent communication and storytelling skills - you make technical solutions feel strategic and actionable Highly self-motivated with strong attention to detail and the ability to thrive in a fast-moving environment A collaborative mindset with a desire to work cross-functionally and win as a team Why You'll Love It Here Competitive base salary: $135,000 - $150,000 with the ability to double this through the achievement of on-target earnings Full medical, dental, vision, competitive 401k plan with a company match, and PTO benefits Flexible remote work environment (U.S. based) Opportunity to lead and grow a major category at a high-growth company Supportive, smart teammates who thrive on solving meaningful challenges A culture that values bold thinking, accountability, and fun How to Apply Sound like a fit? Apply here! At Azira, we don't hire for the box-we hire for the spark. We're building boldly. Join us.
    $135k-150k yearly 45d ago
  • Director, Laboratory - Riverside Methodist Hospital

    Ohio Health 3.3company rating

    Managed care director job in Columbus, OH

    We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position directs planning, organization, and operation of the laboratory services. The position is responsible for the overall coordination of testing processes within the campus and in conjunction with other OhioHealth hospitals and OhioHealth Laboratory Services. Responsibilities And Duties: 60% Manages all aspects of the hospital laboratory services to meet customer needs and support hospital and department balanced scorecard goals. This includes: direct responsibility for Laboratory operations and ownership/coordination of cross-functional, laboratory-related processes through leadership with Nursing, other departments, the medical staff, and administration. The Director is responsible for the development and management of department operating and capital budgets, as well as personnel issues within the department. 15% Ensures Laboratory Department complies with relevant Joint Commission, CAP, CLIA, and FDA standards, as well as any other state/federal/local agency rules or professional standards. Ensures hospital complies with blood handling and use standards as defined by JCAHO and any other state/federal/local regulatory body. 15% Represents the RMH Laboratory Department on appropriate hospital/system committees 10% Participates in other activities within the hospital or system as necessary. Minimum Qualifications: Bachelor's Degree (Required) Additional Job Description: Field of Study: laboratory medicine Field of Study: Advanced degree in healthcare management or business. Work Shift: Day Scheduled Weekly Hours : 40 Department Lab Administration Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
    $89k-164k yearly est. Auto-Apply 60d+ ago
  • Assistant Wellness Director

    Storypoint

    Managed care director job in Columbus, OH

    StoryPoint Gahanna Central LPN Required The Assistant Wellness Director is responsible for the overall direction of clinical resident care services by delivering a 1440 experience, optimizing performance and leading employee connections within our community. Required Experience for Assistant Wellness Director: Licensed Practical Nurse (LPN) or Registered Nurse (RN) registered within the State preferred. Assisted Living/Memory Care experience preferred. Prior supervisory experience required. Earned a degree from an educational institution in health care, mental health or social services profession or be a licensed Health Facility Administrator. Minimum of 1 year of experience with dementia or Alzheimer s residents, or both, within the past 5 years. Minimum of 12 hours of dementia-specific training within the last 3 months. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to communicate effectively before groups of customers or employees of organization. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Proven organization and communication skills. Ability to work successfully through complex situations (ability to problem solve). Accountabilities for Assistant Wellness Director: Lead, manage, and overall accountability for your team and their performance. Revenue, Evaluations & Care Conferences for IL/AL: Responsible for ensuring right care, at the right price with the right staff. Employee Connection: Lead to Employee First by setting clear expectations, giving and receiving regular and honest feedback, and growing and recognizing your staff. Resident & Family Care: Oversee and provide care for our residents and communicate clearly and regularly with their families where appropriate. 1440 Care Standard Accountability: Understanding and leading to our 1440 care standards. Other Key Responsibilities for Assistant Wellness Director: Perform admission and ongoing evaluations of residents quarterly, upon return from Hospital or skilled environment, or change of condition (initiate care conference) and use this information to set measurable goals and outcomes for residents that meet the physical, mental, and psychosocial needs. Obtain written orders for any necessary changes to care plan. Completes 6 hours of dementia-specific training annually to meet the needs or preferences, of cognitively impaired residents and understands current standards of care. Verification of MARS/TARS and communicate with pharmacy to assure accuracy of medication & treatment administration. Reviews occurrence reports submitted by staff members to determine if an assessment/care conference needs to be performed on an existing resident & address any personnel issues which are identified. Schedule educational sessions relating to health for all residents. Communication of all emergency policies and provision of updated information to staff. Work toward continual improvement of the overall organization. Available to work a flexible schedule including on call, weekends, and holidays when necessary. Perform other duties as assigned. General Working Conditions: This position entails standing for long periods of time. While performing the duties of this job, the employee is required to communicate effectively with others, sit, stand, walk and use hands to handle keyboard, telephone, paper, files, and other equipment and objects. The employee is occasionally required to reach with hands and arms. This position requires the ability to review detailed documents and read computer screens. The employee will occasionally lift and/or move up to 25 pounds. The work environment requires appropriate interaction with others. The noise level in the work environment is moderate. Occasional travel to different locations may be required. This classification description is intended to indicate the general kinds of tasks and levels of work difficulty that are required of positions given this title and should not be construed as declaring what the specific duties and responsibilities of any particular position shall be. It is not intended to limit or in any way modify the right of any supervisor to assign, direct and control the work of the employees under her/his supervision. The use of a particular expression or illustration describing duties shall not exclude other duties not mentioned that are of a similar kind or level of difficulty. Equal Opportunity Employer #SP1
    $46k-91k yearly est. 18d ago
  • CCO In Training, Director of Clinical Services

    Pennant Group

    Remote managed care director job

    This opportunity will be on-site in Arizona, Nevada, Utah or Colorado. Cornerstone, part of The Pennant Group family, is currently seeking entrepreneurial-minded leaders with proven results in building and leading exceptional clinical teams - and has a passion for the home health, hospice and home care industry. Join us in making an impact and shaping the future of home healthcare! About the Opportunity: The CCO-in-Training (CCIT) Program is a 12-week, full time paid executive training program designed to prepare outstanding leaders for an opportunity to lead and manage clinical services and teams in a home health, hospice, or home care setting. CCITs learn how to drive results, cultivate a strong team culture, and develop a deep understanding of the unique business model that powers Pennant's success. Successful CCIT graduates may advance to lead one of our thriving agencies or future agencies, with continued mentorship and operational support from experienced clinical partners. As a CCIT, you will gain hands-on practical experience in high quality clinical care services, agency operations, administrative support, and people leadership skills to equip you to take on a more strategic and elevated Director of Clinical Services position (or equivalent). The CCIT program offers mentorship, cross-functional training, and real responsibility in a dynamic environment. Key Responsibilities: Engage in immersive, on-the-job training across clinical, operational and administrative management functions. Shadow department heads and front-line staff to understand the day-to-day rhythm of agency operations, processes, and clinical controls. Take the lead on real-time projects and contribute to meaningful improvements within your host agency. Prepare for a Director-level role by mastering staffing, team engagement, and community growth initiatives. Study relevant state regulations and best practices in home healthcare operations. Align leadership and interpersonal skills with our CAPLICO core values and mission. Qualifications: Current, unencumbered, active license to practice as a Registered Nurse, Speech-Language Pathologist, Occupational Therapist, or Social Worker in the state where services are rendered; must maintain applicable state licensure requirements at hire, and for the entire duration of employment. Minimum of one (1) year of experience required, preferably in a home health or hospice treatment setting. Current and nationally accredited CPR certification. Enthusiasm, passion for working with people, and an internal drive to improve the lives of individuals in our care. Must understand and adhere to the ethical standards of the respective licensure governing board. Must have a valid driver's license, current automobile insurance, and a safe driving record. Open to relocation based on available opportunities About Us: Cornerstone, an affiliate of The Pennant Group (NASDAQ: PNTG), is committed to delivering compassionate, personalized care to patients and families in the comfort of their own homes. As part of the Pennant family-a growing national network with over 180 affiliated locations across 14 states spanning home health, hospice, and senior living-we operate with the independence and flexibility that allow our local leaders to truly make a difference. Pennant Services provides robust clinical, legal, accounting, IT and HR support, enabling our teams to focus on delivering exceptional service and care. We are guided by the core values that shape Pennant's unique culture: Customer Second Accountability Passion for Learning Love One Another Intelligent Risk Taking Celebrate Ownership We believe in empowering our people, fostering excellence, and creating an environment where personal and professional growth thrives. Our culture makes Pennant a truly unique place to work. The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at **************************** #onsite The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at ****************************
    $75k-109k yearly est. Auto-Apply 12d ago
  • Wellness Director

    Brookdale 4.0company rating

    Managed care director job in Dublin, OH

    Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity As Director of Nursing at Brookdale, you will utilize your leadership qualities to inspire, lead and manage the overall operation of the clinical team to provide the highest quality of care and services for our residents. You will proactively build relationships with residents, families, physicians and other healthcare providers for the coordination of exceptional personalized care. You will consistently collaborate with community leadership, mentor and engage your associates and build resident and family satisfaction. Brookdale supports our Nurse Leaders through: Structured six-week orientation, a wealth of online resources, local nurse mentors and ongoing collaborative support. Tuition reimbursement to support your clinical expertise and leadership skills development. Network of almost 700 communities in 40 states to support you should relocation be in your future. This is a great opportunity for a strong nurse leader looking to take the next step in their professional career or for an experienced Director of Nursing looking to join a reputable mission and purpose-driven organization where you can make a contribution. Qualifications & Skills Education as required to obtain state nursing license and state nursing license (LPN/LVN or RN) Driver's license Minimum of 3 years relevant experience, and Clinical leadership experience preferred. Strong working knowledge of technology, proficiency in Microsoft office suite and electronic documentation. Visit careers.brookdale.com to learn more about Brookdale's culture, see our full list of benefits and find other available job opportunities. Enriching lives...Together. At Brookdale, relationships and integrity are the heart of our culture. Do you want to be a part of a welcoming and inclusive community where residents and associates thrive? Our cornerstones of passion, courage, partnership and trust drive everything we do and come to life every day. If this speaks to you, come join our award winning team. Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Part and Full Time Benefits Eligibility Medical, Dental, Vision insurance 401(k) Associate assistance program Employee discounts Referral program Early access to earned wages for hourly associates (outside of CA) Optional voluntary benefits including ID theft protection and pet insurance Full Time Only Benefits Eligibility Paid Time Off Paid holidays Company provided life insurance Adoption benefit Disability (short and long term) Flexible Spending Accounts Health Savings Account Optional life and dependent life insurance Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan Tuition reimbursement Base pay in range will be determined by applicant's skills and experience. Full-time associates in role are eligible for an annual bonus incentive and sales referral bonuses. Temporary associates are not benefits eligible but may participate in the company's 401(k) program. Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year. The application window is anticipated to close within 30 days of the date of the posting. Manages the day-to-day clinical services of a more complex community to ensure residents' healthcare needs are met. Ensures residents are treated with respect and dignity and ensures quality care as residents' healthcare needs change. Supervises and provides leadership, as well as coaching, to licensed nurses and other direct care staff within the community. May be responsible for leading additional clinical leadership team up to five members. The HWD level for each community is determined based on the total complexity of the role. Complexity criteria include, but are not limited to, factors such as size, type of product lines, medication management regulations, 90-day assessment requirements, multiple licensure requirements, state regulatory complexity, and skilled services requiring an RN.
    $47k-81k yearly est. Auto-Apply 36d ago
  • Director of Wellness (Full Time)

    Carriage Court Senior Living

    Managed care director job in Hilliard, OH

    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
    $87k-90k yearly Auto-Apply 60d+ ago
  • Director of Clinical Services

    Newvista Behavioral Health 4.3company rating

    Managed care director job in Columbus, OH

    Job Address: 10270 Blacklick - Eastern Road NW Pickerington, OH 43147 Role: Director of Clinical Services Job Post Title: Director of Clinical Services Solero Behavioral Transitions We provide a safe and supportive environment for individuals struggling with severe mental illness. Our program offers comprehensive care, including individual and group therapy sessions, case management services and life skills training. A mental health residential facility is a place where people receive intensive, specialized care for mental health and or substance abuse issues in a non-hospital setting. Residents receive 24-hour supervision, treatment, and support from mental health experts. The environment is homelike and supportive, and residents participate in therapeutic activities. Shift: M-F, with a weekend rotation Hours: 8-4:30 Perks at Work Healthcare: Medical Packages with Rx - 3 Choices Flexible Spending Accounts (FSA) Dependent Day Care Spending Accounts Health Spending Accounts (HSA) with a company match Dental Care Program - 2 choices Vision Plan Life Insurance Options Accidental Insurances Paid Time Off + Paid Holidays Employee Assistance Programs 401k with a Company Match Education + Leadership Development Up to $15,000 in Tuition Reimbursements Student Loan Forgiveness Programs Approved HRSA Site Approved STAR-LRP Site The Role Itself License/Education/Certification: Formal education program or training in Quality Improvement/Risk Management/Compliance for inpatient or behavioral health settings. Familiarity with healthcare laws, regulations, accreditation standards, state licensure or certification and Best Practices in healthcare compliance program implementation Knowledge of the principals of The Joint Commission and must be well versed in CMS guidelines Knowledge and understanding of the Regulatory Compliance Ohio Department of Mental Health and Addictions Serves as resource for faculty regarding medical record content and regulatory requirements Ability to adapt to change and work under stressful situation Education: Masters degree in social work with LSW and documented experience in group therapy setting. Counselor Degree Must be 21 yrs or older Top of Form License: LSW, LISW, LPC, LPCC, MFT, LMFT Current unencumbered clinical license per state of practice guidelines. Levels of Care Residential Mental Health Services A service activity which uses clinical and medical interventions, including the administration of physician prescribed medications and clinical monitoring, to help stabilize mental health symptoms to for individuals requiring a more structured and supervised environment. Partial Hospitalization Program Comprehensive Mental Health program with intensive treatment services to help individuals prepare for re-entry into all aspects of their lives including home, work, school and relationships. Program Purpose: We are committed to producing the highest level of clinical outcomes for clients and their families. Solero Behavioral Transitions is a trauma-informed, non-coercive treatment program designed to treat individuals struggling with Mental Health symptoms. The Solero's focused mental health rehabilitation includes; Building Resiliency Optimistic outlook Locus of control Sense of self Ability to bounce back Change management Practical Life Skills Problem-solving Money management Time management Personal change Self-awareness Communication Skills Active listening Nonverbal communication Communication skills Social Radar Negotiation skills These are the core concepts that extend into many areas of a client's life and help develop the foundations for recovery and recovery sustainability.
    $62k-83k yearly est. Auto-Apply 53d ago
  • Director, Clinical Care Services - New Mexico, Remote

    Magellan Health 4.8company rating

    Remote managed care director job

    This is a remote position supporting New Mexico. Candidate needs to be licensed in the State where they reside. Maintains accountability for medical management functions to achieve the business and clinical outcomes for the health plan, meeting contract requirements, National Committee of Quality Assurance (NCQA) accreditation standards, and supporting initiatives with providers and members to manage cost of care. Oversees utilization management and criteria-based reviews of care, clinical appeals regarding medical necessity, and the interaction with claims payment policies and processes. Also oversees the health plans 24/7 Nurse Line program and the clinical management of crisis calls. Depending on SBU/product supported, supports goals, contracts, and accreditation requirements of health plan in conducting reviews of clinical interactions and clinical documentation including reviews of case management, utilization management, vendor, and provider records. Collects data following established procedures and analyzes findings for purposes of continuous quality improvement and for internal and external reporting. Interacts with multiple stakeholders internally and externally. Conduct staff audits, process audits and pre-delegation and delegation activities. Reviews audit results with appropriate stakeholder and manages trainings in conjunction with the trainer for individual and/or for unit learning gaps. Directs, coordinates and evaluates efficiency and productivity of utilization management functions. Works closely with SBU and vendors to assure integration, oversight, and efficiency of utilization management and appeals processes and for delegated functions. In collaboration with the national clinical team, assures that all utilization management-related activities meet the standards required for the state contract and NCQA. Leads and organizes the ongoing evaluation of the utilization management program against quality and utilization benchmarks and targets. Identifies opportunities for improvement; organizes and manages cost of care initiatives. Collaborates with local and national leaders including Quality Improvement, Analytics, Finance, Network, and other areas to assure a comprehensive approach to managing quality of care, service, and cost of care. Provides expert input to Finance regarding patterns of utilization and cost and high cost cases. Assures staff selection, training, and evaluation to promote the development of a high quality team and effective transitions of care with the clinical care teams. Works closely with and provides input to national health plan clinical team on program design, policies, procedures, workflows, and correspondence. Collaborates with Network leaders to design and implement successful methods for working with hospitals, home health, and other services providers. Ensures integration and efficiency of Network strategy and vendor relationships with utilization management and claims processes. Works closely with network on the training and evaluation of providers as well in resolving provider related issues. Directs staff who assure quality, inter-rater reliability and standards are met in daily operations. Responsible for resolution and communication of utilization management issues and concerns and corrective action plan activities and reporting. Participates as a member of health plan Quality Insurance Committee and co-chair health plan Utilization Management Committee. Collects, analyzes and prepares record/documents information for projects related to assessing the efficiency, effectiveness and quality of the delivery of managed care services. Prepares monthly performance reports with audit results. Presents findings at provider, customer, UM and CM meetings as needed. Audits and reviews case manager, Health guide, UM staff, vendor, and provider documentation and telephone interactions against health services quality monitoring standards, regulations, accreditation standards and contract requirements. Reviews vendor and/or provider records against clinical and procedural established standards and contract requirements. Leads and conducts ongoing activities which monitor established quality of care standards in the participating provider network, vendors, UM staff, Health Guides, and for case managers. Assists in the planning and implementation of activities to improve delivery of services and quality of care including the development and coordination of in-service education programs for vendors, providers, UM staff, and case managers. Makes recommendations as to required training based upon audit results. Responsible for monitoring and validating internal audit results and/or corrective action plans. Other duties as assigned. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 3+ years in utilization management operations. 5+ years in health care quality improvement. Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following current, active licenses are required: BCBA, LCMFT, LCSW, LMHP, LPC, LPT, LOT or RN. Must have experience overseeing contractual performance standards. Experience with reporting and analyzing managed care utilization data. Strong verbal and written communications skills. General Job Information Title Director, Clinical Care Services - New Mexico, Remote Grade 30 Work Experience - Required Clinical, Management/Leadership, Quality, Utilization Management Work Experience - Preferred Education - Required Bachelor's - Nursing, Bachelor's - Occupational Therapy, Bachelor's - Physical Therapy, Master's - Behavioral Health Education - Preferred License and Certifications - Required BCBA - Board Certified Behavior Analyst - Care MgmtCare Mgmt, LCMFT - Licensed Clinical Marriage and Family Therapist - Care MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare Mgmt, LMHP - Licensed Mental Health Professional - Care MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare Mgmt, OT - Occupational Therapist, State Licensure - Care MgmtCare Mgmt, PT - Physical Therapist, State Licensure - Care MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt License and Certifications - Preferred Salary Range Salary Minimum: $105,230 Salary Maximum: $178,890 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
    $105.2k-178.9k yearly Auto-Apply 10d ago

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