- OhioHealth (Columbus, OH)
- …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
- Humana (Columbus, OH)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG,… more
- Deloitte (Columbus, OH)
- …consulting services to public sector clients + Support engagements focused on Medicaid reimbursement , including actuarial rate development across managed care ... and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie, DSH, UPL, etc.) + Experience with… more
- CVS Health (Columbus, OH)
- …speed to market and to support segment leaders with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. **You will make an impact by:** ... heart, each and every day. **Position Summary** Aetna is recruiting for a Senior Manager, Value Based Contractor who will partner with business development and… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, ... programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex… more
- Molina Healthcare (Columbus, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development… more
- Cardinal Health (Columbus, OH)
- …of insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid , commercial insurance plans, and managed care preferred. + ... aging reports and work patient accounts to ensure timely resolution and reimbursement . + Contact patients regarding past due balance and/or billing questions and… more
- Centene Corporation (Columbus, OH)
- … Medicaid . + Lead population health initiatives with a strong focus on Medicaid while collaborating with partners on Medicare and Marketplace programs. + ... President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies...the direction of Centene and the Ohio Department of Medicaid . While the primary focus is on Medicaid… more
- Humana (Columbus, OH)
- …extraction and analysis technologies + Experience preparing contracts and knowledge of Medicare and other reimbursement methodologies + Financial acumen with ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... years of demonstrated project management experience + Experience partnering with senior leadership on strategic initiatives + Proven planning, preparation and… more
- Molina Healthcare (Columbus, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... regulatory and/or functional requirements related but not limited to coverage, reimbursement , and processing functions to support systems solutions development and… more
- Datavant (Columbus, OH)
- …CRC). + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, ... accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in...titles (eg, Software Engineer) rather than complex ones (eg, Senior Software Engineer). The range posted is for a… more
- Molina Healthcare (Columbus, OH)
- …observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. ... manages a team of medical economics team of professionals. * Collaborates with senior level clinicians and leaders from functional areas such as finance, health care… more