- CVS Health (New Albany, OH)
- …is compliantly and effectively operating in the market. As such, the Lead Director of Medicare Operations supports MAPD and SNP initiatives and ... of the Chief Medicare Officer, may facilitate internal and external Medicare audit activity including CMS and operations integrity audits. Coordinates file… more
- Elevance Health (Columbus, OH)
- …deliver member-centered, lasting pharmacy care. In this pivotal role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account Director ... preserving and deepening relationships with clients which include Elevance Health Medicare Health Plans. This position, structured around geographic regions and… more
- Evolent (Columbus, OH)
- …You'll Be Doing:** **What You'll Be Doing:** Evolent is looking for a Managing Director of Value-Based Operations to join our Primary Care Leadership Team. This ... Medicare in the Shared Savings Program. The Managing Director will report to the SVP Primary Care /...operational teams for each reporting in. The MD will lead our Quality program, with accountability for ECP's Quality… more
- Elevance Health (Columbus, OH)
- …+ Experience as a management consultant. + Domain expertise with health plan operations and back office, Medicare , Medicaid, Grievances & Appeals (G&A), ... of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative...and Billing Organization is looking to hire an Execution Director . Reporting directly to the VP of Grievance &… more
- CenterWell (Columbus, OH)
- …a part of our caring community and help us put health first** The Director , Complex Care Strategy Advancement will play a pivotal role in driving the strategic ... quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will be responsible for assessing the value of… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Associate Director , Actuarial provides actuarial support across a broad range of actuarial and business ... needs for specific product lines. The Associate Director , Actuarial requires a solid understanding of how organization.... Analytics . Forecasting . Risk . Compliance . Operations Decisions are typically related to identifying and resolving… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** As the Associate Director , Salesforce Technology, you will be at the forefront of devising and executing a ... committed to transforming Primary Care through technology and innovation. The Associate Director , Technology Solutions acts as a liaison and collaborates with the… more
- Evolent (Columbus, OH)
- …directly to the Chief Medical Officer. The CCO will lead the Clinical Operations team and work with medical director leadership to ensure consistent and ... be responsible for leadership, professional development, and performance of the clinical operations team. Within the Clinical Services team, the CCO will also have… more
- Prime Therapeutics (Columbus, OH)
- …organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance + ... Lead project management efforts for highly sensitive Compliance initiatives...organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Trinity Health (Grove City, OH)
- …, a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive outreach and ... hospital and center staff members to facilitate the daily operations of the sterile processing area of the Surgical...issues, or needs as they arise to the Administrative Director of Perioperative Services. + Provides performance feedback and… more