- University Hospitals (Cleveland, OH)
- …care within the UH Meds enterprise of pharmacy operations. The Pharmacy Support Liaison must have a strong knowledge of Medicare and Medicaid regulations ... and commercial insurer criteria for payment of home care services. Additionally, they will be responsible for verification of insurance, and benefits for Home Care Pharmacy services - inclusive of new referrals and therapy changes, adjudication of claims and… more
- Cuyahoga County Board of Developmental Disabilities (Cleveland, OH)
- …The Cuyahoga County Board of Developmental Disabilities (Cuyahoga DD) is seeking a Liaison to expedite the process of establishing Medicaid eligibility in order ... in Home and Community-Based Services (HCBS) waivers; assists with maintenance of Medicaid eligibility through Medicaid and HCBS redetermination processes. The… more
- Molina Healthcare (Akron, OH)
- …contractors working on team. Mentors interns on a daily basis. + Acts as liaison between business customers, state, and project management office to ensure all state ... Information Systems, or related field **Preferred Experience** Knowledge of Medicare/ Medicaid IT systems Experience with health services research and reporting… more
- Somatus (Cleveland, OH)
- …resources to adhering to a physician's treatment plan upon discharge. The Hospital Liaison will work with the RNCM, case management and care givers to identify ... Case Managers on appropriate discharge needs of those members. + Hospital Liaison will make contact and engage members, establish positive, supportive relationships… more
- Cleveland Clinic (Beachwood, OH)
- …Joint Commission (TJC), State Department of Health and Centers for Medicare and Medicaid (CMS). Serve as the department liaison to representatives from visiting ... regulatory agencies. + Proactively identify targeted talent communities based upon function and geographies for ongoing recruitment. + Manage, grow, motivate and energize team and function. + Serve as a thought partner on talent market trends, system hiring… more
- Molina Healthcare (Akron, OH)
- **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and ... director, and quality improvement staff. + Facilitates conformance to Medicare, Medicaid , NCQA and other regulatory requirements. + Reviews quality referred issues,… more
- Molina Healthcare (Akron, OH)
- …outreach and coordination of services, including MTM services for Medicare and Medicaid eligible members as well as Medication Adherence Programs for STAR, HEDIS ... staffing coverage is present at all times of operation. * Acts as liaison to internal and external customers to ensure prompt resolution of identified issues.… more
- Molina Healthcare (Akron, OH)
- …and other departments with questions regarding drug coverage. + Acts as a liaison between Molina and its customers (members, providers and pharmacies) with respect ... for workplace and plan location. **Preferred Experience** + Medicare Part D or Medicaid experience. + Managed care experience. To all current Molina employees: If… more
- Molina Healthcare (Akron, OH)
- …to the success of this team. The selected candidate would act as the liaison between the business, vendors , IT, and support Program Managers and Business Analyst ... needs, support to other business units + Strong business knowledge related to Medicaid and Medicare lines of business + Reviews enrollment issue trends and provides… more
- Molina Healthcare (Akron, OH)
- …departments for medication reviews, scheduling appointments, and acting as a liaison between other departments. **Job Duties** + Handles and records inbound/outbound ... is current and up to date. + Effectively communicate general Medicare and Medicaid plan benefits to existing members. + Interact with appropriate primary care… more
- Molina Healthcare (Akron, OH)
- **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and ... Current State Medical License without restrictions (free of sanctions from Medicaid or Medicare) **PREFERRED EDUCATION:** Master's in Business Administration, Public… more
- Elevance Health (Independence, OH)
- …when requested. + May assist with complex cases. + May act as liaison between Medical Management and/or Operations and internal departments. + Maintains and updates ... Skills, Capabilities and Experiences:** Understanding of managed care or Medicaid /Medicare strongly preferred. For URAC accredited areas, the following professional… more
- Bellefaire JCB (Cleveland, OH)
- …and quality of services provided to the child and family and act as liaison when new services/resources need to be sought or developed. + Employ evidence-based ... but not limited to, number of referrals, hours of billable ( Medicaid /insurance) and non-billable services provided (including face-to-face contacts, and cases… more
