- Molina Healthcare (Dayton, OH)
- …with government sponsored programs, including risk revenue management, strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality ... metrics such as HEDIS and STARS, knowledge of coding + Knowledge of medical economics and financial reporting. Must be able to walk stakeholders (internal and external) through basic financial reconciliations. + Excellent leadership skills, especially ability… more
- Molina Healthcare (Dayton, OH)
- …experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Manages member services operations. + Ensures compliance with state and regulatory requirements. + Identifies new ... opportunities for process development. + Develops and implements interventions to address deficiencies and negative trends. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business… more
- Molina Healthcare (Dayton, OH)
- …based on the severity of illness and the site of service. The Mgr , HCS Clinical Policy provides operational management and oversight to integrated Healthcare ... of clinical guidelines. + Facilitates integrated, proactive HCS management, ensuring compliance with state and federal regulatory and accrediting standards and… more