- Alternate Solutions Health Network LLC (Columbus, OH)
- …patients like they are our own FAMILY. Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention ... (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers. Based on this regulation, all of our employees must be fully vaccinated or… more
- CVS Health (Columbus, OH)
- …and supporting) skills. + MUST RESIDE IN OHIO. **Preferred Qualifications** + Medicaid Operations knowledge. + Report creation using QuickBase. **Education** + ... what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at...in managing the day-to-day complex business consultation services to support the organization's goals and objectives. Implements processes and… more
- Humana (Columbus, OH)
- …first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy Organization in order to support the strategic direction ... a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile,...lieu of Service packages that delight key customers and support sustainable health plan operations . + Lead… more
- Humana (Columbus, OH)
- …Lead, Medicaid Clinical & Population Health Strategy, will advance Humana's Medicaid products and capabilities to support the strategic direction and growth ... to maximize ability of limited resources to achieve growth. Candidates will possess Medicaid managed care operations expertise and have experience in designing… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Director, Actuarial of Medicaid Pricing provides actuarial support across a broad range of actuarial and ... capabilities interrelate across the function or segment. The Director, Actuarial of Medicaid Pricing may be responsible for any combination of valuation, pricing,… more
- Humana (Columbus, OH)
- …caring community and help us put health first** The Supervisor, Provider Engagement develops and grows positive, long-term relationships with physicians, providers ... and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The… more
- Humana (Dublin, OH)
- …you Caring, Curious and Committed? If so, apply today! The Consumer Service Operations Professional 2: + Member support , customer service, enrollment, and ... Healthy Horizons in Ohio is seeking a Consumer Service Operations Professional 2 who is responsible for the daily...Through our commitments to wellbeing and work-life balance, we support each associate's personal health, purpose, work style, sense… more
- HealthEdge Software Inc (Columbus, OH)
- … Medicaid , and commercial), payment integrity, and healthcare plan operations (eg, claim life cycle/workflow, network contracting, payment/policy configuration, ... provider relations, medical management, medical economics, audit, compliance) related...(implementation/consulting engagements, strategic user adoption initiatives, and on-going client support ) + Provide the highest level of… more
- Humana (Columbus, OH)
- …Medical Director is responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve moderately ... Behavioral Health Medical Directors will learn Medicare, Medicare Advantage and/or Medicaid requirements, and will understand how to operationalize this knowledge in… more
- Highmark Health (Columbus, OH)
- …of the strategic business and functional infrastructure of the underlying systems that support the respective business platforms for the Medicaid Business Unit ... to benefits, business rules, screen design and functionality, templates, workflows, provider contracts, user task analysis, personalization to different plans, and… more
- Public Consulting Group (Columbus, OH)
- …To learn more, visit www.publicconsultinggroup.com . **Job-Specific Responsibilities** + Provide strong leadership on all Medicare/ Medicaid cost settlement ... (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and...Support the completion of SOC reports on our Medicaid supplemental payment work and services. + Serve as… more
- Humana (Columbus, OH)
- …as well as creating and maintaining response templates. This position also provides support to writers and Proposal Operations in a SharePoint environment. The ... state-specific language and incorporate business development and corporate brand standards + Support Writing team and Proposal Operations and Leadership +… more
- Humana (Columbus, OH)
- …will be adept at evaluating and deploying contemporary digital health products to support people with complex health and social needs. They will work with senior ... to maximize available resources to achieve growth. + Leads National Medicaid Strategic Priorities, effectively develops LTSS-based strategic goals and turns them… more
- Public Consulting Group (Columbus, OH)
- …Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies ... project work across multiple public health care projects, including Medicaid programs + Serve as a subject matter expert...in health care finance, actuarial methods and standards + Support the design and implementation of rate structures and… more
- Plante Moran (Columbus, OH)
- …providers including SNFS, Hospice, HHA, ICF, etc. From reimbursement strategy to operations and everything in between, our integrated solution approach is designed ... Lead and manage strategic engagements focused on preparation of Medicaid and Medicare cost reports + Prepare, review, and...data from a staffing and expense management standpoint + Provide client accounting assistance as requested + Drive top-line… more
- Humana (Columbus, OH)
- …+ Support application teams through various enterprise governance process and provide 'white glove' support to ensure successful implementation. **Use your ... leverage the IT. Additionally, as a Senior Enterprise Architect, you will provide mentorship and guidance to other enterprise, solution, technology, and system… more
- Humana (Columbus, OH)
- …analytic consistency, and data integrity + Experience in managing data to support and influence decisions on day-to-day operations , strategic planning, and ... us put health first** CenterWell's Value-Based Organization is an integrated homecare service provider focused on meeting the needs of Health Plans by serving its… more
- Humana (Columbus, OH)
- …will focus on opportunities to improve member health outcomes, member and provider experience, clinical quality, and savings to medical costs. The Strategy ... with other key stakeholders from across the enterprise (clinical, quality, operations , analytics, and business) and leading the end-to-end project of strategy… more
- Public Consulting Group (Columbus, OH)
- …team. Common locations ae at the individual's home, a CSB/BHA office, a Day Support Program, a licensed residential provider 's location or virtually. + This is ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies… more
- Cardinal Health (Columbus, OH)
- …Health_** Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and ... database + Conducts outbound correspondence when necessary to help support the needs of the patient and/or program +...inquiry + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related… more
