- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (Columbus, OH)
- …with heart, each and every day. **Position Summary** Aetna is recruiting for a Senior Manager , Value Based Contractor who will partner with business development ... support segment leaders with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. **You will make...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Columbus, OH)
- …do it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected ... and best course of action on investigations + Serves as back up to the manager as necessary + Cooperates with federal, state, and local law enforcement agencies in… more
- CenterWell (Columbus, OH)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CenterWell (Columbus, OH)
- …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
- CenterWell (Columbus, OH)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF, ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel:… more
- CVS Health (Columbus, OH)
- …improve outcomes, manage costs, and offer an unmatched experience for our patients. As a Senior Product Manager , you will be a key leader in our organization, ... have the needed support from specialist. You'll work with senior business and engineering leaders to lead a product...digital health solutions + 4+ years as a Product Manager + Experience with data analytics and core healthcare… more
- CenterWell (Columbus, OH)
- …+ Coordinate, review, and analyze documentation and data entry supporting Medicare , Medicaid, and commercial payer requirements to ensure accurate and timely ... requested. + Assure for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures + Participate in special… more