- CVS Health (Columbus, OH)
- …our Manager, Project Management ( Project Manager) role in our Medicare Member Advocacy Center (MAC Team). Medicare 's Member Advocacy Center ... and data analytics. They will also be responsible for member retention initiatives, member engagement oversight, omnichannel...of Medicare knowledge + 1-2 years of project management experience + 1-3 years of… more
- Elevance Health (Columbus, OH)
- …Ability to multi-task while independently and effectively prioritizing work using time management , initiative, project management and problem-solving skills. ... **Audit & Reimbursement III - Medicare Cost Report Audit** **_Locations:_** _This is a...States based position._ **National Government Services** is a proud member of Elevance Health's family of brands. We administer… more
- Humana (Columbus, OH)
- …effectively manage multiple activities + Experience with public sector contract review + Project Management experience + Group Medicare experience is ... simple requests for proposals (RFPs)/request for renewals (RFRs) including full-scale project management , written narratives, and production necessary for final… more
- Elevance Health (Columbus, OH)
- …unit level and ensures operations' effective achievement of objectives. + Coordinates project management across department & divisional line. + Ability to ... **Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** Alternate...project status and progress to business unit senior management . + Ensures accuracy and timeliness of output and… more
- Public Consulting Group (Columbus, OH)
- …and Billing Services + Applied Technology + Outsourcing and Operations + Strategy + Project and Grants Management + Assessments and Feasibility Studies PCG is ... change lives for the better. The firm is a member of a family of companies with experience in...Monitor quality of staff day-to-day performance. + Work with Management to ensure project goals and expectations… more
- Humana (Columbus, OH)
- … management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Humana (Columbus, OH)
- … management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Humana (Columbus, OH)
- … management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Public Consulting Group (Columbus, OH)
- …matrixed environment * Proficiency in Microsoft applications (Outlook, Word, Excel, PowerPoint, Visio, Project ) and project management tools * Ability to ... change lives for the better. The firm is a member of a family of companies with experience in...with clients, vendors, team members to establish and achieve project goals * Address problems through risk management… more
- Public Consulting Group (Columbus, OH)
- …or related field preferred . Experience with GAAP principles . Experience with project accounting. . Experience with Medicare or Medicaid cost reporting ... change lives for the better. The firm is a member of a family of companies with experience in...department and PCG grow and as deemed necessary by management . **Required Skills** + Ability to analyze account fluctuations… more
- Humana (Columbus, OH)
- …concepts (CI/CD, TDD) + 5+ years of experience coaching and mentoring teams on project management practices including Agile, Lean, Kanban, Waterfall. + 8+ years ... software, including full Microsoft suite (Excel, Power automate) + Project management software, Project , Jira,...from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Interview Format** As part… more
- Humana (Columbus, OH)
- …process to identify opportunities for enhanced clinical outcomes, cost control, quality, and member experience. This is a remote opportunity to join a dynamic team ... Lead will analyze complex problems and issues related to member care, care quality/outcomes, and medical cost. This role...of consulting experience + 2 or more years of project leadership experience + Experience in the health care… more
- Medical Mutual of Ohio (Columbus, OH)
- …Skills and Knowledge: . Expert in operation of scheduling software, change management , project leadership, restart/recovery, JCL, DR, and other software utilized ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s… more
- Humana (Columbus, OH)
- …problem solving and proficiency in executing solutions. + Demonstrated excellent skills in project and time management with proven ability to be flexible, adapt ... made toward achieving and maintaining Humana's health plan accreditations for Medicare and Medicaid. The Accreditation Manager's roles and responsibilities include… more
- Prime Therapeutics (Columbus, OH)
- …with regulatory compliance for Medicare /Medicaid/Commercial or ACA drug benefit + Project management experience + Certification or licensure in a related ... Audit Specialist, Sr. - Remote **Job Description** As a member of the Client Audit Management (CAM)...provide quality checks for CAM staff + Demonstrate high-level project management and organization capabilities by effectively… more
- Humana (Columbus, OH)
- …your state of residence without disciplinary action. + Minimum 5 years of project management and/or process improvement experience + Minimum 3 years utilization ... following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements. Begins to… more
- CenterWell (Columbus, OH)
- … management experience and ability to lead teams + Previous program or project management experience + Proven success in leading teams (both direct and ... consumer experiences **Preferred Qualifications** **Previous experience with pharmacy benefits management ** + Previous Commercial, Medicare and/or Medicaid… more
- Humana (Columbus, OH)
- …ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs + Proficiency in ... in Puerto Rico.** + 2 or more years of project leadership experience + 5 years of healthcare experience...+ A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Scheduled Weekly Hours** 40… more
- Humana (Columbus, OH)
- …or mobile environment. + Ensures the course can interface with a Learning Management System, if required. + Collaborates with subject matter experts on appropriate ... technology-based learning solutions. + Develops project documentation, including standards and templates. + Provides technical troubleshooting support as related to… more
- Humana (Columbus, OH)
- …an in-depth evaluation of variable factors. In this role you will provide project based and ad-hoc reporting of key insights for multiple Medicaid markets while ... on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. + Exercises considerable… more