- Elevance Health (Mason, OH)
- ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Elevance Health (Mason, OH)
- **Process Improvement Director -HEDIS** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1hour commute from the ... posted Elevance Health locations. This **Process Improvement Director -HEDIS** will be responsible for enterprise HEDIS improvement and governance programs, with… more
- Molina Healthcare (Cincinnati, OH)
- …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …specific to hospital revenue cycle risk areas highlighted by the OIG, Medicare , State Medicaid, State Insurance Fraud; Managed Care or Governmental Value-Based ... risk areas + Assists in auditing and investigations requested by the System Director , Compliance. + Assists in the development of compliance corrective action plans… more