• Audit & Reimbursement III- Medicare Cost…

    Elevance Health (Columbus, OH)
    …Ability to multi-task while independently and effectively prioritizing work using time management , initiative, project management and problem-solving skills. ... **Audit & Reimbursement III - Medicare Cost Report Audit** **_Locations:_** _This is a...States based position._ **National Government Services** is a proud member of Elevance Health's family of brands. We administer… more
    Elevance Health (01/30/25)
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  • Director of Medicare Risk Adjustment…

    Elevance Health (Columbus, OH)
    …unit level and ensures operations' effective achievement of objectives. + Coordinates project management across department & divisional line. + Ability to ... **Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** Alternate...project status and progress to business unit senior management . + Ensures accuracy and timeliness of output and… more
    Elevance Health (02/04/25)
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  • Staff Accountant II - Medicare / Medicaid…

    Public Consulting Group (Columbus, OH)
    …or related field preferred . Experience with GAAP principles . Experience with project accounting. . Experience with Medicare or Medicaid cost reporting ... change lives for the better. The firm is a member of a family of companies with experience in...department and PCG grow and as deemed necessary by management . **Required Skills** + Ability to analyze account fluctuations… more
    Public Consulting Group (01/25/25)
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  • IT Project Manager I-IV

    Medical Mutual of Ohio (Dublin, OH)
    …in leading enterprise projects and teams in compliance with the Company's defined IT project management standards with the goal of delivering project ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....with support, in compliance with the Company's defined IT project management standards with the goal of… more
    Medical Mutual of Ohio (12/04/24)
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  • Project Lead - Disability Advocacy…

    Public Consulting Group (Columbus, OH)
    …and Billing Services + Applied Technology + Outsourcing and Operations + Strategy + Project and Grants Management + Assessments and Feasibility Studies PCG is ... change lives for the better. The firm is a member of a family of companies with experience in...Monitor quality of staff day-to-day performance. + Work with Management to ensure project goals and expectations… more
    Public Consulting Group (01/16/25)
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  • Medical Director--Claims Management

    Humana (Columbus, OH)
    management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
    Humana (01/28/25)
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  • Medical Director - Mid West Region

    Humana (Columbus, OH)
    management + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
    Humana (01/30/25)
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  • Medical Director - Gulf South

    Humana (Columbus, OH)
    management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
    Humana (12/03/24)
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  • Site Reliability Engineering Manager

    Medical Mutual of Ohio (Dublin, OH)
    …people and experience with the listed architectures. + Functional understanding of project management principles and their application to Infrastructure projects ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s… more
    Medical Mutual of Ohio (01/03/25)
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  • Mgr, IT Infrastructure Transformation

    Medical Mutual of Ohio (Dublin, OH)
    …people and experience with the listed architectures. + Functional understanding of project management principles and their application to Infrastructure projects ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....around town, just for being a Medical Mutual team member . + The opportunity to earn cash rewards for… more
    Medical Mutual of Ohio (01/23/25)
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  • Medicaid Certification Consultant

    Public Consulting Group (Columbus, OH)
    …matrixed environment * Proficiency in Microsoft applications (Outlook, Word, Excel, PowerPoint, Visio, Project ) and project management tools * Ability to ... change lives for the better. The firm is a member of a family of companies with experience in...with clients, vendors, team members to establish and achieve project goals * Address problems through risk management more
    Public Consulting Group (01/15/25)
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  • Case Manager, RN

    CAI (Columbus, OH)
    …such as Disease/Chronic Condition Management , Behavioral Health, and Complex Case Management + Collaborate with the member 's health care and service delivery ... for a Case Manager, RN to provide community-based care coordination/ management for our client's members in the state of...Full-Time and Hybrid. **_Due to our end client and project work, all candidates must be United States citizens._**… more
    CAI (02/01/25)
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  • IT Operations Technician I-IV

    Medical Mutual of Ohio (Columbus, OH)
    …Skills and Knowledge: . Expert in operation of scheduling software, change management , project leadership, restart/recovery, JCL, DR, and other software utilized ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s… more
    Medical Mutual of Ohio (12/10/24)
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  • Senior Value-Based Programs Reporting Analyst

    Humana (Columbus, OH)
    …+ Experience working with data visualization tools (eg PowerBI or other) + Project Management Experience + Advanced Knowledge of Humana's Data Infrastructure ... on moderately complex to complex issues regarding technical approach for project components, and work is often performed without direction. Exercises considerable… more
    Humana (01/30/25)
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  • Lead Infrastructure Architect - Disaster Recovery

    Humana (Columbus, OH)
    …priorities in a fast-paced environment using discernment, organization, structure and time management . + Provide project leadership for the purpose of planning, ... translate business requirements to technology designs and solutions with ongoing management of technical solution architecture artifacts. + Main point of contact… more
    Humana (01/31/25)
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  • Medicaid Market Development Advisor

    Humana (Dublin, OH)
    …stakeholders to understand and improve the market **Additional Information** + Strong project management and organizational skills + Ability to analyze ... and external meetings + Proficiency in Microsoft PowerPoint, Excel and other presentation, project management and reporting tools As part of our hiring process… more
    Humana (01/31/25)
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  • Sr. Value-Based Programs Professional

    Humana (Columbus, OH)
    …operational decisions, and oversee implementation progress and milestones + Develop and maintain project plans, and other project management functions + ... operations, value-based care, and/or provider reimbursement and analytics + 3+ years of project management experience and operating in a matrixed environment +… more
    Humana (01/29/25)
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  • Client Audit Specialist, Sr. - Remote

    Prime Therapeutics (Columbus, OH)
    …with regulatory compliance for Medicare /Medicaid/Commercial or ACA drug benefit + Project management experience + Certification or licensure in a related ... Audit Specialist, Sr. - Remote **Job Description** As a member of the Client Audit Management (CAM)...provide quality checks for CAM staff + Demonstrate high-level project management and organization capabilities by effectively… more
    Prime Therapeutics (01/07/25)
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  • Senior Rx Clinical Programs Pharmacist (VSP/PT)

    CenterWell (Columbus, OH)
    management experience and ability to lead teams + Previous program or project management experience + Proven success in leading teams (both direct and ... experiences **Preferred Qualifications** + Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience… more
    CenterWell (01/29/25)
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  • Senior RX Clinical Programs Pharmacist

    CenterWell (Columbus, OH)
    management experience and ability to lead teams + Previous program or project management experience + Proven success in leading teams (both direct and ... consumer experiences **Preferred Qualifications** **Previous experience with pharmacy benefits management ** + Previous Commercial, Medicare and/or Medicaid… more
    CenterWell (01/21/25)
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