- Molina Healthcare (Covington, KY)
- …as appropriate. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract , network development and management, or project ... provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare... Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare… more
- Molina Healthcare (Covington, KY)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Covington, KY)
- …supports assigned contracts with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes reports according to ... Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider 's office,… more
- Elevance Health (Mason, OH)
- …Healthcare (Pharmacy) Applications i** s responsible for providing analytical support to the Cost of Care and/or Provider Contracting organizations. **How ... realized and recommends modifications as applicable. + Recommends standardized practices to optimize cost of care . + Educates provider contractors on… more
- Molina Healthcare (Covington, KY)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... 5:00PM EST. (No Weekends or Holidays) Job Summary Provides support for care management/ care coordination activities and collaborates with multidisciplinary team… more
- Elevance Health (Cincinnati, OH)
- **Behavioral Health - Care Manager II** **Location:** _Virtual:_ This role enables associate to work virtually full-time, with the exception of required in-person ... granted as required by law. The **Behavioral Health - Care Manager II** is responsible for managing psychiatric or...access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines… more
- Molina Healthcare (Covington, KY)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. * Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Molina Healthcare (Covington, KY)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. + Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Molina Healthcare (Covington, KY)
- …management standardization, and cost -effective quality outcomes in a managed care environment. Contributes to overarching strategy to provide quality and ... and implementation of behavioral health medical policies, peer review processes, provider education, and contract reviews. + Represents the organization… more
- Bon Secours Mercy Health (Cincinnati, OH)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... patient testing or procedures, including interacting with physician offices, other health care providers and staff in departments that provide services to… more
- City of Cincinnati (Cincinnati, OH)
- …Participates in the development and administration of assigned program budget. Create cost estimates and other contract documents. Identify and apply for ... phases of multiple projects.? Check construction plans, design calculations, or cost estimations to ensure completeness, accuracy, or conformity to engineering… more
- Bon Secours Mercy Health (Cincinnati, OH)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... responsible for managing and leading 340B Program Analysts and Auditors who provide supportive services for respective covered entities, child sites, and contract… more
- Elevance Health (Mason, OH)
- …more complex medical transplant issues. + Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... member access to medically necessary, quality healthcare in a cost effective setting according to contract . +...and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management… more
- Curtiss-Wright Corporation (Cincinnati, OH)
- …performance of complex, highly technical projects in accordance with contract requirements and company policies, procedures and guidelines. **Location:** Cincinnati, ... will be evaluated when extending an offer._ **We Take Care of Our People** ! Paid Time Off **I**...that all requirements and expectations are addressed effectively. + Provide technical input on the generation of proposals for… more
- CDM Smith (Covington, KY)
- …federal background check. * Knowledge of design review, construction administration, cost estimating, scheduling, and contract management. * Demonstrates ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- City of Cincinnati (Cincinnati, OH)
- …and other projects, varying with assigned area of responsibility; and to provide complex professional assistance to an assigned Engineering Supervisor or other ... the City and Contractor on DOTE construction projects. This position will ensure the contract is administered to the fullest extent and is completed according to the… more
- Molina Healthcare (Covington, KY)
- …provide cohesive direction towards company goals. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... professionals, in some or all of the following functions: utilization management, care management, care transitions, behavioral health, long-term services and… more
- GE Aerospace (Cincinnati, OH)
- …alternate casting technologies. **Job Description** **Roles and Responsibilities** + Provide process and product technical leadership for the Castings commodity, ... investment castings (SX or equiax), with demonstrated yield, capability, and cost improvements + Hands-on expertise across investment casting special processes (wax,… more
- Robert Half Office Team (Sharonville, OH)
- …Customer Service Representative to join our team in Sharonville, Ohio. In this long-term contract role, you will serve as the primary point of contact for customers, ... ensuring their needs are met efficiently and with care . This position offers an excellent opportunity to showcase your communication skills and your ability to… more
- CDM Smith (Covington, KY)
- …writing detailed damage descriptions. Develops and reviews scopes of work and cost estimates, including code and standard requirements. * Reviews and analyzes ... claim eligibility. Develops or evaluates hazard mitigation proposals and benefit- cost analyses. Works with applicants to prioritize their projects, facilitates… more