- Elevance Health (Independence, OH)
- ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Cleveland Clinic (Cleveland, OH)
- Director Medicare Coverage Analysis Join Cleveland Clinic's Main Campus where research and surgery are advanced, technology is leading-edge, patient care is ... work collaboratively with the institutes and research billing office to create a Medicare coverage analysis billing grid for research studies with a patient care… more
- Molina Healthcare (Akron, OH)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s status as a ... Founded in 1934, Medical Mutual is the oldest and one of...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- Elevance Health (Seven Hills, OH)
- **Process Improvement Director -HEDIS** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1hour commute from the ... posted Elevance Health locations. This **Process Improvement Director -HEDIS** will be responsible for enterprise HEDIS improvement and governance programs, with… more
- Molina Healthcare (Akron, OH)
- …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s status as a ... Translates resulting insights into actionable recommendations to support decision making across Medical Mutual. Partners closely with the Director of Competitive… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s status as a ... reside within a 50-mile radius of the Brooklyn, OH Medical Mutual office._** Founded in 1934, Medical ...Performs other duties as assigned. **Lead Sourcing Specialist** **Assists Director of Procurement in the strategic sourcing initiatives to… more
- Gentiva (Akron, OH)
- …diagnosis, treatment, consultation, and follow-up under the direction of the Palliative Medical Director or Primary Care physician. **As a Nurse Practitioner, ... tests within the scope of professional practice. Order treatments and durable medical equipment as indicated. + Communicate clinical findings to the PSC Physician… more
- Molina Healthcare (Akron, OH)
- …therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics ... + Provides medication therapy management including examination of member medical records, performing a comprehensive medication review, and communicating with… more
- Elara Caring (Akron, OH)
- …and continuing education opportunities for all employees + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer match + Paid ... year in the home care industry + Knowledge of Medicare /Medicaid home care benefits, policies, and procedures + Valid...to perform job tasks You will report to the Director Nursing or Clinical Administrator. _This is not a… more
- Gentiva (Independence, OH)
- …in the **Cleveland/Independence** area. You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible ... referrals/inquiries in a timely, professional, and compassionate manner, including triage of medical concerns within scope of practice. + Preparing for, serving on,… more