- Zurich NA (Columbus, OH)
- Managed Care , Claims Vendor Management Sr Specialist 118916 Zurich North America is seeking a Managed Care , Claims Vendor Management ... United States. **About the Role** As a Senior Specialist in Managed Care and Claims Vendor Management, you will play a key role in administering… more
- Molina Healthcare (Columbus, OH)
- …and strong system knowledge of QNXT and other state specific applications concerning Managed Care Enrollment. + Responsible for ensuring timely reconciliation of ... education and experience **Required Experience** 5-7 years Enrollment-related experience in Managed care or Medicare setting **Preferred Education** Graduate… more
- Humana (Columbus, OH)
- …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
- City of Columbus (Columbus, OH)
- …compensation, claims processing and dispute resolution, contract interpretation and compliance, managed care , or direct patient care . Test/Job Contact ... Proposal (RFP) processes. + Participates in employee benefit system testing, vendor census reporting, and COBRA programming. + Administers employee benefits… more
- HealthEdge Software Inc (Columbus, OH)
- …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
- Takeda Pharmaceuticals (Columbus, OH)
- … Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- CVS Health (New Albany, OH)
- …documentation. **Required Qualifications:** + 7 years' experience in Medicare or equivalent managed care operational and technical skills. + Subject matter ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...+ Drives successful market results by improving provider and vendor performance, as well as implementing tactics to address… more