Medical Director- Commercial Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Candidates must reside near a location in the following states: CO, OH, IN, KY, MO, and WI.
Schedule: Monday through Friday 8am-5pm CST or EST (If candidate is living in Colorado MST is fine). Weekend rotation coverage 5-6 weekends a year.
The Medical Director- Commercial will be part of the Central Region team responsible for utilization review case management for local Commercial business in the CO, OH, IN, KY, MO, and WI markets. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates.
How you will make an impact:
* Supports clinicians to ensure timely and consistent responses to members and providers.
* Provides guidance for clinical operational aspects of a program.
* Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.
* May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.
* Serves as a resource and consultant to other areas of the company.
* May be required to represent the company to external entities and/or serve on internal and/or external committees.
* May chair company committees.
* Interprets medical policies and clinical guidelines.
* May develop and propose new medical policies based on changes in healthcare.
* Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes.
* Identifies and develops opportunities for innovation to increase effectiveness and quality.
Minimum Requirements:
* Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
* Must possess an active unrestricted medical license to practice medicine or a health profession.
* Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US.
* Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
* For Health Solutions and Carelon organizations (including behavioral health) only, minimum of 5 years of experience providing health care is required. Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency.
Preferred Qualifications:
* General Surgeon or Primary Care specialties preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $238,320 to $393,228
Locations: Colorado, and Columbus, OH
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Job Level:
Director Equivalent
Workshift:
1st Shift (United States of America)
Job Family:
MED > Licensed Physician/Doctor/Dentist
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$238.3k-393.2k yearly 15d ago
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Medical Director [Physician Administrator 3]
Dasstateoh
Columbus, OH
Medical Director [Physician Administrator 3] (2600003J) Organization: Youth Services - Central OfficeAgency Contact Name and Information: *********************** Unposting Date: Feb 12, 2026, 11:59:00 PMWork Location: DYS William Green Building 30 West Spring Street 5th Floor Columbus 43215Primary Location: United States of America-OHIO-Franklin County-Columbus Compensation: NegotiableSchedule: Full-time Classified Indicator: UnclassifiedUnion: Exempt from Union Primary Job Skill: MedicalTechnical Skills: Juvenile CorrectionsProfessional Skills: Attention to Detail, Collaboration, Teamwork Agency OverviewJOIN OUR TEAM! About Us…Our mission at the Ohio Department of Youth Services (DYS) is to improve Ohio's future by habilitating youth and empowering families and communities. We believe that all youth will be given an opportunity to live up to their greatest potential and staff are our greatest resource.DYS is the juvenile corrections system for the state of Ohio. DYS is statutorily mandated to confine felony offenders, ages 10-21, who have been adjudicated and committed by one of Ohio's 88 county juvenile courts. During their stay with DYS, youth are engaged in programming that is designed to address their criminological and behavioral needs. DYS reaches thousands of youth in facilities and those on parole.Our Guiding Principles…Demonstrate staff are our greatest resource Treat everyone with respect Cultivate a trauma responsive environment for staff and youth to thrive Provide the best support and services for youth and families Advance our culture of inclusion through understanding and appreciating staff and youth differences Commit to and encourage collaboration and continuous improvement to produce better outcomes for those we serve Celebrate collective successes and support one another through opportunities to improve To learn more about DYS, please visit our website by clicking here Job DescriptionDYS is seeking an enthusiastic Administrator to serve as the Medical Director (Physician Administrator 3) for the agency to include three juvenile correctional facilities. The position will be based in our downtown Columbus office but may require travel to our facilities and regional locations, as needed. Duties include, but are not limited to:Development of policy and procedure for all medical services.Formulates recommendations and plans to improve delivery and quality of integrated medical services.Advises DYS Superintendents and other officials on relevant medical services for the youth.On call 24/7 for medical advice/crisis. Assists with development and assures implementation of health care programs for DYS youth.Evaluates medical care being delivered to youth through the quality assurance program to identify opportunities for improvement.Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:
Medical Coverage
Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
Childbirth, Adoption, and Foster Care leave
Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsLicense to practice medicine as issued by State Medical Board pursuant to Sections 4731.14 & 4731.281 of Revised Code.Must have valid Driver's License Job Skills: Medical, Juvenile Corrections, Collaboration, Teamwork, Attention to DetailSupplemental InformationBACKGROUND CHECK NOTICE:The final candidate selected for this position will be required to undergo a pre-employment drug screening and criminal background check that includes results from BCI and FBI, Ohio Department of Public Safety and Ohio Department of Taxation. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration.PRE-SERVICE TRAINING:The final candidate selected will be required to attend 3 weeks of mandatory, paid Pre-Service Training at the DYS Training Academy in Orient, Ohio. Pre-Service Training is Monday - Thursday, 7:00 am - 5:00 pm.DYS is a “qualifying employer” for purposes of the federal Public Service Loan Forgiveness [PSLF] program.ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.
$177k-281k yearly est. Auto-Apply 13h ago
Medical Director Risk Management
Ohiohealth 4.3
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:**
The MDRM works daily with the Risk Managers and the lawyers and staff in the OGC addressing concerns impacting OhioHealth's liability with respect to professional liability claims and incidents and the review and oversight of practitioner claim trends from the organization's claims/incidence database. In partnering with System Quality, this role also identifies primary areas of risk and works with Quality to help focus on the organizational impact of risk, whether patient safety, reputational, or financial. This position will include reviewing potential claims for reporting to the OGC. This role is accountable for providing medical advice and support to the Risk Managers and OGC. This person must also be able to effectively work with the outside malpractice defense counsel to provide general medical advice with respect to malpractice claims defense when requested. The person will also support the patient grievance process at GMC and RMH.
**Responsibilities And Duties:**
60%
The Medical Director, Risk Management ("MDRM) will provide expertise and advice to support the Risk Management function throughout OhioHealth. The primary job duties of this individual are as follows, and as assigned:
The MDRM will provide expert medical analysis of incidents, risk matters, and claims and may interact with patients and family regarding the same. The MDRM's general function is to be the primary medical expert/resource/advisor to the Risk Management department and the Office of the General Counsel ("OGC). This will include interaction with in-house lawyers and outside malpractice defense counsel on incidents and claims as requested.
The MDRM will regularly attend the Risk Management/OGC Reserves meetings and provide advice and input on standard of care in connection with claims against OhioHealth for medical malpractice.
The MDRM, in conjunction with the other OhioHealth Risk Managers, may from time to time cooperate and provide information and expertise to the Quality and Patient Safety and Peer Review staff and leadership to help manage risk and prevent patient care errors.
The MDRM will be the primary medical expert reviewer of incidents and potentially compensable events (PCEs) as part of the OGC/RM "Significantly Involved Provider (SIP) program and provide SIP analyses to the Risk Managers and OGC lawyers managing litigation.
40%
For Grant Medical Center (GMC) and Riverside Methodist Hospital (RMH), the MDRM will:
Support, through collaboration with Patient Experience/Customer Service, the patient grievance process. In that regard, the MDRM will assist in or provide case evaluations, disclosures, review patient concerns and safety events, and make periodic calls and visits to patients and families when a physician or administrative representative is needed. The MDRM will attend the grievance committee meetings at GMC and RMH and participate in related system activities as appropriate.
Support the campus VP of Clinical Affairs and collaborate with hospital leadership on matters affecting patient services.
Oversee the system patient rights hotline and perform medical record reviews for potential patient harm as needed.
**Minimum Qualifications:**
Doctor of Osteopathic Medicine, Medical DoctorOLP - Ohio Licensed Physician - Ohio Medical Board
**Additional Job Description:**
**SPECIALIZED KNOWLEDGE**
Experience in peer review, quality and safety.
**Work Shift:**
Day
**Scheduled Weekly Hours :**
40
**Department**
Legal
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
$231k-325k yearly est. 60d+ ago
Medical Director -Spine
CVS Health 4.6
Delaware, OH
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.
And we do it all with heart, each and every day.
Position SummaryAetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers.
That experience gives us a unique opportunity to help transform health care.
We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.
Practice Spine Surgery.
.
.
.
From Your Home! Aetna, a CVS Health Company, is hiring physicians that are board certified in Orthopedic Spine or Neurosurgery to expand Aetna's medical management program.
This is an exciting opportunity to address member needs across the continuum of care and provide clinical expertise to the spine team.
The medical directors are responsible for precertification reviews of claim determinations, and provide clinical, coding and reimbursement expertise using multiple computer based applications.
This is a full time position, offering a salary with yearly raises, health insurance, 401K, stock plans and other benefits and an opportunity to use your skills but work regular hours in a remote position from anywhere in the United StatesThis is a remote based (work at home) based anywhere in the US.
Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home.
The Medical Director (Spine) will be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically.
Expands Aetna's medical management programs to address member needs across the continuum of care.
Supports the Medical Management staff ensuring timely and consistent responses to members and providers.
Leads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.
Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer based applications.
Required Qualifications* 2 or more years of experience in Health Care Delivery System e.
g.
, Clinical Practice and Health Care Industry.
* Active and current state medical license without encumbrances.
* M.
D.
or D.
O.
, Board Certification in a Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically.
Preferred Qualifications* Previous healthcare insurance experience.
Education* 2 or more years of experience in Health Care Delivery System e.
g.
, Clinical Practice and Health Care Industry.
* Active and current state medical license without encumbrances.
* M.
D.
or D.
O.
, Board Certification in a Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience.
Pay RangeThe typical pay range for this role is:$174,070.
00 - $374,920.
00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
This position also includes an award target in the company's equity award program.
Our people fuel our future.
Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be.
In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *************
cvshealth.
com/us/en/benefits We anticipate the application window for this opening will close on Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$174.1k-374.9k yearly 39d ago
Associate Medical Director
MJ Morgan Group 3.6
Columbus, OH
Onsite | Full Time | Sign-On Bonus
Our client is expanding their clinical leadership team in Columbus! We are looking for a mission-driven Associate Medical Director who is passionate about delivering high-quality, value-based care to medically complex and socially vulnerable populations. Our client provides a comprehensive, team-based model that integrates primary care, behavioral health, pharmacy, nutrition, imaging, community outreach, and more under one roof.
What You'll Do
Clinical Leadership & Care Delivery
Provide exceptional primary care to a panel of members (70-80% clinical time).
Lead and mentor physicians and APPs in delivering coordinated, high-touch care.
Guide interdisciplinary teams (nursing, BH, care management, pharmacy, social work).
Support daily population health huddles to drive quality and utilization outcomes.
Operational & Strategic Impact
Serve as a key clinical leader alongside the Medical Director.
Represent the client with community partners, hospital systems, and payer organizations.
Shape clinical protocols, care pathways, and support staff development.
Collaborate across teams to meet engagement, quality, and cost-of-care goals.
Member Care & Population Health
Manage chronic and acute conditions, including urgent/same-day visits.
Coordinate transitions of care across ER, hospital, SNF, and home settings.
Utilize evidence-based practices and PCMH principles.
Leverage EHR tools to track and achieve quality metrics.
What You Bring
Active, unrestricted medical or nursing license in Ohio.
5+ years of clinical experience with leadership of interdisciplinary teams.
Background in outpatient clinics, community-based care, or inpatient settings.
Experience mentoring clinicians and supporting clinical development.
Strong communication, critical thinking, and organizational skills.
Passion for population health, care transformation, and serving vulnerable communities.
Ready to Make an Impact? Apply now to join a mission-driven team delivering transformative care.
#HC123
$165k-333k yearly est. 60d+ ago
Financial Services Tax - Real Estate Director
PwC 4.8
Columbus, OH
**Specialty/Competency:** Industry Tax Practice **Industry/Sector:** Asset and Wealth Management **Time Type:** Full time **Travel Requirements:** Up to 20% A career in our Financial Services Tax practice, within Corporate Tax services, will provide you with the opportunity to help our clients meet their tax obligations while managing the impact tax has on their business. You'll advise clients on their local and overseas tax affairs, while acting as a strategic consultant related to business analysis, managing working capital, and profit sharing for partners. You'll also help organisations understand the pricing implications of goods and services between related parties, as well as providing advice on tax implications of deals.
Our team helps our Financial Services clients navigate the frequently changing and complex national and international tax environment related to stringent capital requirements, management of operational tax risks, and tax implications of investing in different jurisdictions. You'll help our clients with their tax structuring while helping to address the challenges of the continuously changing tax world, both locally and globally.
To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.
As a Director, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:
+ Support team to disrupt, improve and evolve ways of working when necessary.
+ Arrange and sponsor appropriate assignments and experiences to help people realise their potential and support their long-term aspirations.
+ Identify gaps in the market and spot opportunities to create value propositions.
+ Look for opportunities to scale efficiencies and new ways of working across multiple projects and environments.
+ Create an environment where people and technology thrive together to accomplish more than they could apart.
+ I promote and encourage others to value difference when working in diverse teams.
+ Drive and take ownership for developing connections that help deliver what is best for our people and stakeholders.
+ Influence and facilitate the creation of long-term relationships which add value to the firm.
+ Uphold the firm's code of ethics and business conduct.
**The Opportunity**
As part of the Financial Services Tax team you are expected to lead the way as technology-enabled tax advisors who provide benefits through digitization, automation, and increased efficiencies. As a Director you are expected to set the strategic direction, lead business development efforts, and oversee multiple projects while maintaining impactful executive-level client relations. You are expected to provide exceptional technical knowledge and specialization, coupled with the One Firm knowledge that brings everything PwC offers to solve our clients' needs.
**Responsibilities**
- Set the strategic direction for the Financial Services Tax team
- Lead business development initiatives to drive growth
- Oversee multiple projects to achieve top-quality delivery
- Maintain executive-level client relationships
- Provide technical proficiency and industry insights
- Foster a culture of digitization and automation
- Equip professionals to succeed in complex transactions
- Leverage One Firm knowledge to address client needs
**What You Must Have**
- Bachelor's Degree in Accounting
- 6 years of experience
- CPA, Member of the Bar or other tax, technology, or finance-specific credentials may qualify for this opportunity
**What Sets You Apart**
- Broad knowledge of tax compliance methods
- Strategy consulting for Real Estate Trusts
- Thorough knowledge of partnership structures
- Advanced technical skills in real estate services
- Identifying and addressing client needs
- Developing and sustaining profound client relationships
- Preparing and presenting complex written and verbal documents
- Leading teams to generate a vision and establish direction
- Utilizing automation and digitization in professional services
Learn more about how we work: **************************
PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: ***********************************
As PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law.
For only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.
Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: ***************************************
The salary range for this position is: $150,000 - $438,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: ***********************************
\#LI-Hybrid
$150k-438k yearly 60d+ ago
Director, Home Health Grievances & Appeals
Centerwell
Columbus, OH
**Become a part of our caring community and help us put health first** The Director Denials Management provides leadership for the audit, appeal and review process to preserve and recover revenue while maintaining the highest level of clinical and regulatory integrity and compliance. Manages the Denials Management data analytics, denial and appeal process.
The Director, Home Health Grievances & Appeals assists members, via phone or face to face, further/support quality related goals. Investigates and resolves member and practitioner issues. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.
**Responsibilities:**
+ Oversee the process for direction and support to clinical and operational leadership regarding Medicare and governmental audit trends, denials, and any CMS initiative and/or demonstration projects.
+ Collaborates with leadership team in the development of an education plan to improve processes to preserve and recover revenue.
+ Analyzes region-wide outcome indicators to measure achievement of quantitative and qualitative standards. Assists in the development, implementation and analysis of internal and external benchmarking programs to measure the region's effectiveness in improving performance
+ Maintains region-wide Performance Improvement program which includes Customer Satisfaction, complaints, infection monitoring, Incident Reporting, and quarterly branch PI activity
+ Provides feedback and recommendations for changes to policies and processes, procedures and systems to enhance measures taken to improve performance
+ Communicate with Corporate leadership, Regional and Divisional leaders as appropriate to resolve issues that may place patients or the company at risk
+ Oversee educational in-services based on analysis of PI data and activities Acts as a resource for the Operations Support team and communicates Performance Improvement results
+ Participate in special projects and performs other duties as assigned.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree in Nursing or related field
+ 10-15 years progressively responsible experience in home health or hospice industry that includes performance improvement and outcomes measurement
+ 5 years' experience in a supervisory or teaching role
+ Thorough knowledge of health care policy, industry and related clinical practice
+ Knowledge in the interpretation and application of regulations and performance improvement standards
+ Strong Project management principles and clinical policy development/implementation required
+ Expert knowledge of all Medicare regulations and appeals processes
+ Excellent analytical skills with ability to interpret and apply regulatory requirements
+ Excellent verbal/written communication and presentation skills
+ Advanced knowledge with Payer requirements, ADR requests, Denials, Appeals, RAC/ZPIC and CERT responses
+ Must be able to work well independently and in a team environment
+ Excellent communication and organization skills
+ Strong attention to detail
+ Healthcare industry experience preferred
+ Must read, write and speak fluent English
+ Must have good and regular attendance
+ Approximate percent of time required to travel: 30%
+ Performs other related duties as assigned
**Preferred Qualifications**
+ Master's Degree preferred
+ Licenses/Certification: RN, PT or OT preferred
+ More than 3 years of grievance and appeals experience
+ Strong knowledge in Microsoft Access or experience with SQL Server databases
+ Previous experience processing medical claims
+ Bilingual (English and Spanish); with the ability to read, write, and speak English and Spanish
**Additional Information**
**SSN Alert Statement**
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
**Interview Format**
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
**WAH Internet Statement**
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$126,300 - $173,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-30-2026
**About us**
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
$126.3k-173.7k yearly Easy Apply 20d ago
Clinical Director
Optum 4.4
Columbus, OH
Explore opportunities with Caretenders, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
Sign On Bonus $7,500.00
As the Clinical Director, you will oversee and direct the patient care operations of the home care facility. This includes: coordinating and completing assigned projects to effectively support the immediate and long range objectives of the company; oversight of the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care; implementing and maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered. This position also acts as a liaison with management staff and other departments throughout the company.
Primary Responsibilities:
Coordinates and completes assigned projects to effectively support the immediate and long-range objectives of the company
Oversees the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care
Implements and maintains administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations.
Enhances the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered
All CMS and state regulations must be followed regarding supervision of nursing services
If Clinical Director is not an RN, Executive Director/Administrator or Patient Care Manager must be designated as supervising RN for nursing services unless state regulations dictate otherwise
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Current and unrestricted RN licensure in the state of practice or PT/OT/SLP, must have current applicable license in the state
Current CPR certification
Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation
#LHCjobs
Preferred Qualifications:
1+ years of supervisory and/or management experience in home health setting or related healthcare setting
Ability to manage multiple tasks simultaneously
Able to work independently
Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$71.2k-127.2k yearly 5d ago
HOME HEALTH CARE - DIRECTOR OF NURSING
Pricy Staffing & Homecare Agency LL
Columbus, OH
Job DescriptionJob Type: Full-time / Part -time We are seeking an experienced and skilled Director of Nursing to lead our home health care team. The successful candidate will be responsible for overseeing the nursing department, ensuring high-quality patient care, and driving clinical excellence. This leadership role requires a strong clinical background, excellent communication skills, and the ability to manage and develop staff.
Key Responsibilities:
1. Leadership and Management:
- Provide leadership and direction to the nursing staff, including recruitment, training, and development.
- Foster a culture of excellence, compassion, and safety.
- Manage staffing, scheduling, and budgeting for the nursing department.
2. Clinical Oversight:
- Ensure high-quality patient care and outcomes through regular visits, audits, and feedback.
- Develop and implement clinical policies, procedures, and guidelines.
- Collaborate with physicians, therapists, and other healthcare professionals to ensure comprehensive care.
3. Quality Improvement:
- Develop and implement quality improvement initiatives to enhance patient outcomes and satisfaction.
- Analyze data and metrics to identify areas for improvement.
- Implement evidence-based practices to drive clinical excellence.
4. Regulatory Compliance:
- Ensure compliance with regulatory requirements, including OASIS, Medicare, and Medicaid.
- Maintain accreditation standards and survey readiness.
5. Staff Development:
- Develop and implement staff education and training programs.
- Mentor and coach nursing staff to enhance their skills and knowledge.
6. Communication and Collaboration:
- Communicate effectively with patients, families, staff, and other stakeholders.
- Collaborate with interdisciplinary teams to ensure seamless care transitions.
Requirements:
- Education: Bachelor's degree in Nursing required; Master's degree preferred.
- Licensure: Current RN licensure in the state of practice.
- Experience: Minimum 5 years of experience in home health care, with at least 2 years in a leadership role.
- Certifications: CPHQ, QIAL, or other relevant certifications preferred.
- Skills:
- Strong leadership, management, and communication skills.
- Ability to analyze data and drive quality improvement initiatives.
- Excellent problem-solving and critical thinking skills.
What We Offer:
- Competitive salary and benefits package.
- Opportunity to lead a dynamic team.
- Professional development and growth opportunities.
If you're a motivated and experienced nursing leader looking for a new challenge, we'd love to hear from you!
$81k-135k yearly est. 28d ago
Wellness Director
Brookdale 4.0
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 47d ago
Director Specialty Networks Product
Corvel Healthcare Corporation
Dublin, OH
Job Description
The Director, Specialty Networks Product is a strategic leadership role within CorVel's Network Services division. This position is responsible for overseeing the full product life cycle of the Pharmacy Benefit Management (PBM) and Ancillary Benefit Management (ABM) offerings, as well as future specialty network services products. The Director will drive the development, execution, and growth of these products, ensuring alignment with CorVel's business objectives and delivering exceptional value to clients.
This is a remote role. Candidate residing in Eastern or Central time zones is preferred.
Key Responsibilities:
Lead and manage PBM and ABM products, with full ownership of end-to-end product life cycle, including strategy, development, launch, and ongoing optimization
Develop and maintain a comprehensive product roadmap for PBM, ABM, and emerging specialty network offerings
Serve as the strategic connection point across internal and external stakeholders to ensure product alignment and effective communication
Ensure regulatory and contractual compliance for all specialty network services products
Monitor financial performance, including margins and customer metrics, and drive initiatives to improve profitability and client satisfaction
Support and streamline RFP responses and promote common guidelines for product pricing and margins
Minimize product silos and foster cross-product alignment within the specialty networks portfolio
Promote operational efficiency by reducing duplicative efforts and establishing standardized processes
Drive coordinated specialty networks strategy and enhance cross-product alignment
Knowledge, Skills & Abilities:
Strong knowledge of workers' compensation ancillary services, PBM operations, medical cost containment, and regulatory frameworks
Deep familiarity with workflows such as diagnostics scheduling, DME fulfillment, home health coordination, and transportation/translation management
Understanding of retail, mail-order, and clinical pharmacy solutions including DUR, formulary management, opioid risk mitigation, and pharmacy network contracting
Strong analytical acumen, with the ability to translate complex data into actionable insights and product decisions
Exceptional communication, collaboration, and stakeholder-management skills
Education & Experience
Bachelor's degree required; advanced clinical or business degree preferred
7+ years of experience in workers' compensation, ancillary services, PBM management, or healthcare product strategy
Experience within a TPA, managed care company, PBM, or network management environment strongly preferred
Proven track record leading cross-functional teams in a technology-enabled healthcare organization
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $95,950 - $149,130
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL:
CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
$96k-149.1k yearly 7d ago
Director, Ambulatory Services - New Albany
The Ohio State University 4.4
New Albany, OH
Screen reader users may encounter difficulty with this site. For assistance with applying, please contact ********************************. If you have questions while submitting an application, please review these frequently asked questions.
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Job Title:Director, Ambulatory Services - New AlbanyDepartment:Ambulatory Services | 161 and Hamilton Administration
Scope of Position
The Director of Operations will be accountable for directing and overseeing the daily operations of the OSUWMC Outpatient Care New Albany - a Medical Office Building (MOB), and Ambulatory Surgical Center (ASC) totaling 250,000 gross square feet on 31 acres of land with over 20 different clinical services offered. This role will be responsible for achieving building-wide operational metrics, including financial performance, patient satisfaction, employee engagement, and service levels for administrating shared services supporting the outpatient care campus. This position will act as an executive liaison to the surrounding communities and participate in community engagement efforts to meet the community's needs and build OSUWMC's brand and contributions.
Position Summary
The Director is the operational leader of the Outpatient Care New Albany. The Director leads the effort to develop actions and structure to achieve annual employee engagement, patient satisfaction, access, quality, financial performance goals, and other key metrics of the entire facility's clinical operations. The Director will partner with ambulatory services leadership, physician faculty leaders, service line leaders, and clinic managers to ensure that daily operations are seamlessly delivered. This position provides leadership input for program and service development - promoting the collaboration between all services to meet staffing, patient satisfaction, quality metrics through a team-first and multi-disciplinary approach. The Director is expected to partner with the Medical Center's community and civic outreach and engagement teams to develop and implement strategies and actions to improve the community's health and increase the Medical Center's contributions.
Minimum Qualifications
Bachelor's Degree in Business Administration or related field. 8 years of relevant experience required. 12 or more years of relevant experience preferred.
Additional Information:Location:Ohio State Outpatient Care New Albany (1027) Position Type:RegularScheduled Hours:40Shift:First Shift
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.
The university is an equal opportunity employer, including veterans and disability.
As required by Ohio Revised Code section 3345.0216, Ohio State will: educate students by means of free, open and rigorous intellectual inquiry to seek the truth; equip students with the opportunity to develop intellectual skills to reach their own, informed conclusions; not require, favor, disfavor or prohibit speech or lawful assembly; create a community dedicated to an ethic of civil and free inquiry, which respects the autonomy of each member, supports individual capacities for growth and tolerates differences in opinion; treat all faculty, staff and students as individuals, hold them to equal standards and provide equality of opportunity with regard to race, ethnicity, religion, sex, sexual orientation, gender identity or gender expression.
$73k-124k yearly est. Auto-Apply 12d ago
LTC/SNF Nursing Unit Manager
Dublin 3.6
Dublin, OH
Job Title: Nursing Unit Manager (RN/LPN) Employment Type: Full-Time About Us Dublin Post Acute is a skilled nursing and long-term care facility committed to providing high-quality, compassionate care in a supportive and team-focused environment. We are seeking a dedicated and experienced Nursing Unit Manager (UM) to lead clinical operations on one of our nursing units and ensure excellence in resident care.
Position Summary
The Nursing Unit Manager is responsible for overseeing the daily clinical and operational functions of an assigned unit. This role ensures compliance with state and federal regulations, promotes quality resident outcomes, supports staff development, and collaborates with interdisciplinary teams to maintain a safe and efficient care environment.
Key Responsibilities
Manage and supervise nursing staff on assigned unit
Ensure compliance with Ohio Department of Health and CMS regulations
Oversee resident assessments, care plans, and clinical documentation
Monitor quality measures, incident reports, and infection control practices
Provide staff coaching, education, and performance management
Collaborate with physicians, therapy, admissions, and administration
Participate in audits, surveys, and quality improvement initiatives
Address resident and family concerns professionally and promptly
Qualifications
Active RN or LPN license in the State of Ohio (required)
Minimum 2 years of experience in a skilled nursing or long-term care setting
Prior leadership or charge nurse experience preferred
Strong clinical judgment and organizational skills
Knowledge of state and federal survey process
Excellent communication and team leadership abilities
What We Offer
Competitive salary based on experience
Supportive leadership team
Opportunities for growth and advancement
Comprehensive benefits package (medical, dental, vision, PTO, 401k)
Positive, team-oriented work culture
$62k-79k yearly est. 8d ago
Wellness Director
Brookdale Senior Living 4.2
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.
$33k-56k yearly est. 47d ago
Managed Care Resource
Ensign Services 4.0
Columbus, OH
About the Company ESI currently serves over 350 health care operations that employ over 48,000 employees across 14 states. These operations have no corporate headquarters or traditional management hierarchy. Instead, they operate independently with support from the “Service Center” - a team of accounting, legal, human resources, benefits, compliance, payroll, construction, training and information technology resources. Service Center human resources employees are dedicated subject matter consultants who guide and advise field personnel. This structure allows on-site leaders and caregivers to focus on day-to-day issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people. About the Opportunity The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the healthcare industry. The Consultant will provide guidance regarding development of managed care relationships and rate negotiation, ensuring timeliness and rate appropriateness.
Additionally, the Consultant will negotiate contracts for new locations, assist with ensuring that contracts are updated for new services and help with contract cancellations, denials and appeals.
Essential Functions and Responsibilities
Establish, implement and evaluate the strategic plan(s) that will ensure each local operation the ability to optimize financial performance through rates and increased census.
Engage in complex levels of contract development and negotiation, including risk agreements using utilization, claims and market data with health plans and direct service agreements with physicians, physician organizations and hospitals and ancillary providers.
Identify, develop and maintain an effective relationship with contracted health plans and managed care regulatory agencies.
Manage complex and high-profile health plan negotiations. Actively draft and negotiate contracts in the health care operations and health care plan functional areas.
Assist in analysis and coordination of amendments, reimbursement, and language changes.
Assess resource utilization, cost management and negotiate effectively.
Monitor industry changes, trends and events to proactively identify opportunities to increase market penetration and performance improvement.
Understands the competitive pricing levels in the local market and improves the company's cost position through unit costs strategies.
Strategizes for facility census growth and retention.
Teach, Train and Instruct facility level personnel on how to operationalize the contract.
Interact with facility personnel on utilization, clinical results and managed care census.
Qualifications:
Knowledge of managed care contracting language, requirements, and methods to support the development and maintenance of contract compliance, contract language review and contract analysis.
Must be knowledgeable about the managed care environment, including capitation, PPO, HMO, IPA, ACO and POS.
Knowledge of CPT-4, HCPCS, Revenue and ICD coding.
Expert in Skilled Nursing Managed care plans.
Experience in successful operationalizing managed care contracts in the skilled nursing environment.
Knowledge of contracts and contractual interpretations for payment and benefit issues.
Working knowledge of medical terminology, claims payment, contract negotiations, and problem resolution; ability to work collaboratively in a team setting.
Communicate effectively at all organizational levels and in situations requiring instructing, persuading, negotiating, consulting, and advising.
Ability to deal with responsibility with confidential matters. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
Strong analytical mind, with problem solving skills, an aptitude for accuracy, and attention to detail.
Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
Excellent verbal and written communication skills, as well as excellent critical thinking skills.
Computer savvy (Contract Logix, MS Word, MS Outlook & Excel).
Ability to be flexible, be readily adaptable, and work in a rapidly and constantly changing environment.
Present in facilities on a weekly basis, (currently as deemed appropriate).
Desired Qualifications
Must live in Ohio, preferably in the Columbus area.
Preference for bachelor's degree in business administration, management or health care administration.
Willing to travel up to 80% of the time (as deemed appropriate)
Highly desire at least 2 years' experience with Managed Care contracting.
Additional Information Wage Rate: Depending on Experience Position Type: Full-time, exempt employee Benefits: Medical, dental, vision, life & AD&D insurance plans, 401(k) with matching contribution, vacation, sick and holiday pay Location: Candidate must reside in the Columbus, Ohio area. Ensign Services, Inc. is an Equal Opportunity Employer. Pre-employment criminal background screening required.
$69k-92k yearly est. 60d+ ago
Clinical Director / BCBA
ICBD Holdings
Westerville, OH
Clinical Director (BCBA) - ABA Centers of Ohio
Westerville, OH
Leadership Opportunity
Are you a BCBA interested in taking your career in a new direction? Our Clinical Director is responsible for monitoring the daily clinical operations of a single clinic location providing ABA therapy services. The Clinical Director ensures a clear line of communication between BCBAs, RBTs, and other team members.
Why We're the Best Place to Be in ABA!
Dedication to Better Outcomes - Smaller caseloads combined with our established clinical infrastructure mean we can focus on delivering high-quality care and lasting impact for children and families
Unlimited Career Growth - Enjoy long-term opportunities to advance your career without the pressure of private equity investors
On-Demand Clinical Support - Access continuous training and resources through our ABA Academy of Excellence to stay at the top of your game
Investment in Talent - We hire top talent and invest in developing our RBT teams, ensuring the best care for our clients and stability for our BCBAs
Commitment to Improving Autism Care - We're serious about innovation and change, as evidenced by having our own diagnostic teams and sponsorship of the Autism Research Laboratory at Temple University
What You'll Do
Manage BCBAs and RBTs to ensure clinical quality
Supervise the daily implementation of behavior intervention, treatment plans, and client documentation
Give direct verbal/written feedback to BCBAs and RBTs regarding clinical implementation, including modeling
Conduct behavior and skill-based assessments and treatment plans for clients admitted into the region as needed
Support BCBAs in extended assessment opportunities (FBA, FA, preference assessment, etc.)
Make monthly check-in phone calls with families
Support the ABA Academy of Excellence training program by analyzing regional IOA and treatment integrity data
Travel for assessments, oversight of clinical team, and support for high-risk clients
Requirements
Requirements
BCBA certification
Pennsylvania State Licensure
5 years of experience in the ABA field (preferred)
Must maintain clean background/drug screenings and driving record
Benefits
Special, Full-Time BCBA Benefits
401(k) program with generous employer match up to 6%
Performance bonuses (average $2,700 twice yearly)
BCBA referral bonuses ($5,000)
RBT referral bonuses ($500)
Tuition reimbursement for ongoing education (up to $2,500 per semester)
21 paid days off (15 days of PTO, which increases with tenure, plus 6 holidays)
Medical, dental, vision, long-term disability, and life insurance
CEU reimbursement
Mileage reimbursement
About ABA Centers of Pennsylvania
ABA Centers of Ohio is a great place to work! Don't take our word for it, though. We're listed in Inc. magazine's Best in Business list for “Health Services,” honoring companies that have made an extraordinary impact in their fields and on society.
Recruiter ID: #LI-BA1
ABA Centers of Ohio participates in the U.S. Department of Homeland Security E-Verify program.
$79k-126k yearly est. Auto-Apply 7d ago
Program Director
CMR Recruiting
Columbus, OH
Job Description
Program Director at a Behavioural Health Facilities
Compensation: $80,000 per year
Job Type: Full-time
Benefits: Group Health, Dental, Vision, Life and Disability Insurance, 401k, PTO
Are you passionate about making a difference in others' lives? Do you pride yourself on your positive attitude and dedication to providing top-notch care? Are you looking to join a compassionate and supportive team? We have an extraordinary opportunity for a Division President of Residential Services. We are offering COMPETITIVE with AMAZING BENEFITS and great WORK LIFE BALANCE. If so, we'd love to have you on board!!
Position Description:
The Program Director for Residential Services will provide strategic leadership and operational oversight to ensure the effective delivery of primary mental health care programs. This role involves managing multiple residential service locations, maintaining compliance with regulatory standards, and promoting a supportive and collaborative environment for both staff and clients. The Program Director will guide program development and implementation to align with the organisation's mission of delivering high-quality, evidence-based treatment and support. They will be responsible for overseeing residential services across Pennsylvania and Ohio.
Qualifications for Program Director:
Experience in residential program management or adolescent behavioural health.
Strong leadership and staff-management skills in fast-paced clinical settings.
Solid understanding of trauma-informed care and crisis intervention.
Knowledge of Ohio regulations for residential mental health programs.
Bachelor's required; Master's preferred.
Energetic, organised, and effective during growth and change.
Responsibilities for Program Director: (include but are not limited to):
Oversee daily operations of the adolescent inpatient/residential mental health program.
Supervise direct care staff, shift leads, and support consistent therapeutic structure.
Ensure compliance with state regulations and maintain a safe, trauma-informed environment.
Collaborate with the Executive Director and clinical team on treatment planning and crisis support.
Help implement new programming and support the transition into the new, modernised facility.
Maintain communication with families, referral partners, and regulatory bodies as needed.
If you're a skilled and experienced Program Directorof Residential Services looking for a challenging and rewarding opportunity, want YOU to apply!
#MISCEZ
$80k yearly 26d ago
Director of Nursing
Wallick Communities 3.8
Columbus, OH
Job Type: Full time Pay Rate: up to $100k plus bonus Make a Difference-And Own Your Future At Wallick Senior Living, our team understands that senior living is not just a job, but a calling. We take pride in caring for and empowering our residents as they choose to enjoy their golden years with us. With 1,000+ employees and a mission to open doors to homes, opportunity, and hope, we take pride in fostering a supportive and collaborative work environment where every employee-owner plays a vital role.
A Career with Wallick Senior Living Means…
A Unique Approach to Senior Living : Our associates power Wallick's approach to senior living that goes beyond care to ensure our residents live their best lives through meaningful activities, delicious meals and round-the-clock support.
Pay-on-Demand: access your money as you earn it.
Exceptional Benefit Package : Health, dental, vision insurance effective within 2 weeks of starting your new job . Other benefits like gym membership reimbursement, paid parental leave, 401K, and more!
Work-Life Balance: Paid time off, including paid parental leave.
Supportive Culture and Rewarding Work: A team-oriented environment where associates make a meaningful impact by helping individuals maintain independence and quality of life.
Resident Stories That Stay with You : From Maurine, who found an “instant family” to Evelyn, who recently celebrated her 105th birthday with us, our residents enjoy a sense of community that is created by you !
Career Growth: Tuition reimbursement, t raining, professional development, and advancement opportunities within a company that invests in its people.
Employee Owned, Resident Focused : As a 100% employee-owned company, your daily work (supporting our residents) also contributes to your financial future by sharing in our profitability.
What You'll Do
Provide leadership and daily instruction to the nursing department staff.
Ensure appropriate staffing levels are maintained.
Ensure proper dispensing and documentation for medications.
Oversight of the move-in & move-out process according to governing regulations.
Maintain positive relationships with customers, vendors, associates, residents and their families.
Oversight of compliance as it relates to the nursing department.
Perform other related duties as assigned.
What We're Looking For
Active and unincumbered Registered Nurse license (RN) with 2 years of experience in a nursing leadership role.
Will consider an equivalent amount of education and experience.
Should possess proficiency in operating a computer and Microsoft Office.
Should possess strong clinician skills and customer service skills.
Must have the ability to effectively communicate with the workforce, vendors, residents and family members.
Make complex decisions requiring a high degree of analytical skills and judgment.
Decisions may affect any or all internal departments, as well as the community.
Valid Driver License
Wallick's Mission & Values
At Wallick Communities, we believe in opening doors to homes, opportunity , and hope for our residents , associates, and community . Our core values guide everything we do:
Care - We show compassion and respect for everyone.
Character - We do the right thing, even when no one is looking.
Collaboration - We work together to achieve more.
At Wallick, we celebrate Diversity, Equity, Inclusion + Belonging (DEI+B) in our workplace and communities , creating an environment where associates feel welcome, respected, and empowered to bring their authentic selves to the great work they do every day.
For nearly 60 years, it has been at the core of our organization's culture that all Wallick associates come to a safe and inclusive place to work. Wallick does not discriminate based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, or other non-merit-based factors.
Join Us and Become an Employee-Owner!
If you're ready to make a difference in people's lives while securing your financial future, apply today!
*Employment is contingent upon passing a pre-employment background check and drug screen
$100k yearly 1d ago
Program Director
Beacon Specialized Living 4.0
Columbus, OH
The Program Director oversees assigned Beacon locations to ensure that company goals, budgets, and clinical effectiveness targets are met. They support Care Team Managers by ensuring adequate staffing and resources for high-quality care, and keep department heads informed of staffing, compliance, and operational concerns. The Program Director plans and co-chairs monthly staff meetings, ensuring that agendas are coordinated, and documentation is filed.
They also ensure the consistent application of policies and procedures, monitor Care Team Managers' workload, and review incident reports for timely submission to regulatory agencies. The Program Director communicates with regulatory agencies, assists the compliance department with corrective action plans, and manages Census, payroll costs, and EBITDA targets.
Additionally, they ensure accurate time-and-attendance reporting, manage staffing needs, and oversee new employee orientation and training compliance. The Program Director addresses personnel issues with HR, Compliance, and Executive Leadership, provides feedback on performance reviews, and manages the DSP leveling program.
Education and Qualifications:• Bachelor's degree in human service preferred• Minimum of two (2) years' experience of previous management or supervisory experience in a residential care environment• Effective oral and written communication skills
Work Environment:• This is a full-time on-site position requiring regular rotation between Beacon locations within the assigned caseload.• While performing the duties of this job, the employee regularly works in a typical home setting or in the community at various stores, restaurants, entertainment venues, etc. Work may involve the treatment of non-cooperative individuals with psychosocial problems and needs, or chronic and acute health problems.
$37k-48k yearly est. 13d ago
Director of The Writers Workshop and Programs
Kenyon College Inc. 4.2
Gambier, OH
The Kenyon Review seeks a strategic, collaborative, and mission-driven Director of The Writers Workshop and Programs to lead the administration, planning, and continuous development of residential and online adult Writers Workshops. Reporting to the Editor of The Kenyon Review, this full-time role is central to ensuring the ongoing excellence, growth, and impact of KR's adult workshop and programs.