- 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
- Elevance Health (Columbus, OH)
- …Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- CVS Health (Columbus, OH)
- …in a health plan, health system or provider organization + 3+ years of Medicare experience + Proven ability to interact with, influence and collaborate with internal ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...includes an award target in the company's equity award program . Our people fuel our future. Our teams reflect… 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
- OhioHealth (Marion, OH)
- …implementing, communicating, managing and monitoring the needs of the physician contracting program . This role is a subject matter expert, with current knowledge of ... is to: (a) lead and manage the physician contracting program by ensuring all individual physician and physician group...of the Inspector General, The Joint Commission, Center for Medicare & Medicaid Services, Internal Revenue Service, etc. This… 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)
- …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)
- …CenterWell Medical Group, a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group will provide ... , a new virtual care delivery group within CenterWell Senior Primary Care, Humana's Primary Care Organization. This group...the state. . Graduate of accredited MD or DO program of accredited university . Board certification or eligible… 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)
- …is not guaranteed. There also may be opportunity to cover other aspect of the program , such as covering PTO for APPs in CenterWell Medical group (phase 1). There are ... **Knowledge of HEDIS measures and quality indicators** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice… more