- 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 (Cleveland, 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
- ChenMed (Maple Heights, OH)
- …We're rapidly expanding and we need great people to join our team. The Director , Network is to be the business and clinical relationships partner to the Regional ... and post-acute providers, and payers in pursuit of improving outcomes and medical cost. Relationship goals include maximizing understanding of the ChenMed care… more
- Elevance Health (Independence, OH)
- ** Director I Care Consultant-OH** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1 hour commute of the posted ... Elevance Health Ohio locations. The ** Director I Care Consultant-OH** is responsible for strategy and implementation of Provider Success programs in the state of… more
- Molina Healthcare (Cleveland, 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-9, ICD-10… more
- Option Care Health (Cleveland, OH)
- …and delivering presentations within Option Care and externally with customers (ex. medical director , head of case management, executive c-suite individuals). ... oncology, or transplant. + Basic understanding of billing and reimbursement procedures for hospital, medical offices, and Medicare (B/D + benefits) as well as … more
- Molina Healthcare (Cleveland, OH)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/Risk, Director of Value Based Programs, medical economics/actuaries and local health ... program & contract design and implementation for marketplace, Medicaid and/or Medicare + Experience in a complex healthcare delivery environment, specifically with… 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