Medical Mutual of Ohio.
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Ohio
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Long-term. -
Full-time.
Established in 1934, Medical Mutual is the earliest and among the biggest medical insurance business based in Ohio. We offer assurance to more than 1.6 million Ohioans through our premium health, life, impairment, oral, vision and indemnity strategies. We provide completely guaranteed and self-funded group protection, consisting of stop loss, in addition to Medicare Advantage, Medicare Supplement and private strategies.
Medical Mutual’ s status as a shared business implies we are owned by our insurance policy holders, not investors, so we do not response to Wall Street experts or pay dividends to financiers. Rather, we concentrate on establishing services and products that permit us to much better serve our consumers and the neighborhoods around us and assist our members attain their finest possible health and lifestyle.
Provides medical proficiency to promote the shipment of high quality, expense reliable, (member centric) treatment. Adds to the accomplishment of scientific quality; quality rankings enhancement, proper inpatient and outpatient usage, cost, compliance, development and focused enhancement which efforts are regularly carried out and effectively carried out to attain objectives.
Responsibilities
- Provides medical competence to the usage evaluation procedure and decisions.
- Provides pre-determination evaluations and evaluations of claims decisions, offering medical, coding and compensation knowledge.
- Ensures compliance with scientific objectives through tracking of care management efficiency.
- Ensures the suitable and most cost efficient expense reliable healthcare is gotten.
- Recommends modifications and improvements to present handled care, evaluation standards, and medical requirements based upon scientific understanding of healthcare shipment systems, usage techniques, repayment approaches and treatment procedures.
- Assists in advancement and analysis of medical policy, consisting of medical requirement requirements, scientific practice standards, and brand-new innovation evaluations.
- Provides assistance to case management group in the coordination of quality care.
- Performs other responsibilities as appointed.
Qualifications
Qualifications
Education and Experience:
- MD or DO from a certified medical school with an active, unlimited (state) license to practice medication in United States
- Minimum of 5 years of recognized (medical) care practice experience needed
- Physician customer experience in the insurance coverage market chosen
Professional Certification( s)
- Board Certification, in nationally acknowledged specialized (ABMS or AOA) is needed
- Active Unrestricted license to practice medication in United States
Technical Skills and Knowledge:
- Foundational windows based computer system abilities, consisting of typing, data processing, discussion, and web research study abilities.
- Strong understanding of combination of evidence-based medication and handled care concepts.
PHYSICAL DEMANDS/WORK ENVIRONMENT:
- Performs operate in a workplace setting with moderate levels of sound, sitting for extended periods of time, utilizing computer systems and phones, and with direct exposure to fluorescent lighting.
Medical Mutual is wanting to grow our group! We genuinely worth and regard the skills and capabilities of all of our workers. That’s why we provide a remarkable bundle that consists of:
A Great Place to Work:
- Top Workplace in Northeast Ohio. Every year we’ve gotten this acknowledgment!
- On-site wellness center at the majority of areas. Delight in individual fitness instructors, towel service, locker space, weight space, elliptical devices, and a range of classes!
- On-site lunchroom serving hot breakfast and lunch, at a lot of places. Options varying from buffet, made to purchase, cold and hot sandwiches, or a range of meals prepared fresh daily. Corner store at the majority of areas
- Employee discount rate program. Discount rates at numerous locations around town, simply for being a Medical Mutual employee
- Business Casual clothes
Excellent Benefits and Compensation:
- Competitive settlement strategies
- Employee benefit program
- 401( k) with business match and an extra business contribution
- Excellent medical, oral, vision, and special needs insurance coverage
An Investment in You:
- Career advancement programs and classes
- Mentoring and training to assist you advance
- Education repayment approximately $5K each year
About Medical Mutual:
We aim to develop assurance. Our consumers can trust us to do things ideal and to assist them get worth from their health insurance. We’re the biggest health insurance company in Ohio and for over 85 years, we’ve been serving our members and the Ohio neighborhoods where they live and work. Medical Mutual is a Top Place to Work in Northeast Ohio with extraordinary profession chances that provide obstacle, development and a fantastic work/life balance. We desire skilled, ingenious, and driven individuals to assist us continue to be the very best medical insurance option of Ohioans and assist make Ohio the very best it can be! Our headquarter structure lies in the heart of downtown Cleveland and we have numerous workplaces throughout the state. Join us at one near you!
At Medical Mutual and its household of business we commemorate distinctions and are equally bought our staff members and our neighborhood. We are happy to be an Equal Employment Opportunity and Affirmative Action Employer. Certified candidates will get factor to consider for work despite race, color, religious beliefs, sex, sexual preference, gender understanding or identity, nationwide origin, age, marital status, veteran status, or impairment status.
We preserve a drug-free work environment and carry out pre-employment drug abuse and nicotine screening. Medical Mutual and its household of business are thought about a federal professional. The federal government is needing that all staff members of its professionals be completely immunized. To be in compliance with this federal requirement, Medical Mutual needs COVID-19 vaccinations, or certifying exemption documents, for all staff members. Evidence of vaccination status is needed sometimes of hire.
Medical Mutual of Ohio.
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Apply Now.
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