- Molina Healthcare (Covington, KY)
- …combination of education and experience **PREFERRED EXPERIENCE:** + Experience working with Medicaid , Medicare, and Marketplace enrollment data . To all current ... **Job Description** **Job Summary** Manages the activities of the Data Analytics and Reporting team. Performs research and analysis of complex healthcare claims … more
- Elevance Health (Cincinnati, OH)
- **SCA Data Technician** **Locations:** This position is virtual. Ideal candidates will live within 50 miles of one of the following PulsePoint locations; Hingham, ... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. Pay: the...PA - $18.54 Denison, TX - $18.17 The **SCA Data Technician** is responsible for conducting research and collecting… more
- Sanofi Group (Cincinnati, OH)
- Immune Hematology Manager - Ohio Valley **Job Description:** The Immune Hematology Manager (IHM) is responsible for effectively applying promotional and selling ... information for Sanofi Pharmaceuticals' products to designated targets/accounts. + Exceptional business acumen leading to the creation of clear, comprehensive … more
- Lundbeck (Cincinnati, OH)
- Neuroscience Account Manager - Cincinnati, OH Requisition ID: 5659 Location: Cincinnati, Ohio, US **Territory: Cincinnati, OH - Neuroscience** Target area for ... on our journey of growth! As a Neuroscience Account Manager , this is an incredible opportunity to join the...demonstrate strong capability in the following areas: **ESSENTIAL FUNCTIONS:** ** Business Planning & Account Leadership** - Ability to use… more
- Elevance Health (Mason, OH)
- …and reporting on data related to one or several but very similar business metrics and issues Medicaid state directed provider program payments. **How you ... will make an impact:** * Develops and analyzes business performance reports (eg claims data , provider...regulatory requirements, and other ad hoc submissions. * Prepares Medicaid provider state directed programs and other non-claim payments.… more
- Elevance Health (Mason, OH)
- …+ Proficiency within SQL, SAS, Excel, or equivalent. + Proficiency in analyzing Medicaid claims data . + Experience analyzing and building valued based care ... **How you will make an impact:** + Performs varied data analyses which may include developing moderately complex ROI...contracts for the Medicaid line of business . + Experience reconciling… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...but are not limited to: + Analyzes and interprets data and makes recommendations for change based on judgment… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Director I Medicare Operations** ... is responsible for directing multiple business function operations teams on Tier I contract with...(NGS) a contractor for the Centers for Medicare and Medicaid Services. + Medicare Integrity Operations includes but is… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...will make an impact** : + Analyzes and interprets data and makes recommendations for change based on judgment… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. **Location:** **This is a virtual ... claim review of Medicare helpful. + CMS (Centers Medicare Medicaid Services) experience. _If this job is assigned to...experience. _If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Lead** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division within the Department of Health...and training lower level staff + Analyze and interpret data with recommendations based on judgment and experience +… more
- Elevance Health (Cincinnati, OH)
- …will make an impact:** + Functions as the single point of contact for the Business or IT partners for their IT needs. + Leads small teams on initiating, developing, ... new or existing process, methodologies and practices through observation, research, and data analysis. + Monitors adoption and use of processes, tools, and practices… more
- Elevance Health (Mason, OH)
- …claims. **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data ... that may impact more than one company health plan, line of business , and/or state. + Effectively establish rapport and ongoing working relationships with… more
- Elevance Health (Cincinnati, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Project Leader** is responsible ... and develops documentation. + Researches, compiles, extrapolates and validates data used to forecast staffing needs and work flows,...issues. + Assists in managing project scope to ensure business needs are met and the project scope as… more
- Molina Healthcare (Cincinnati, OH)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more
- Elevance Health (Cincinnati, OH)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. **Pay:** The pay for this ... routine nature. Responsible for maintaining compliance activity, professional customer service, and data processing and balancing. **How you will make an impact** +… more
- Elevance Health (Cincinnati, OH)
- …policies, and editing rules, as well as conducts clinical research, data analysis, and identification of legislative mandates to support draft development ... is strongly preferred. + Knowledgeable of the application of Medicaid , Medicare or Commercial reimbursement policies and guidelines. +...They are how we achieve our strategy, power our business outcomes and drive our shared success - for… more
- Molina Healthcare (Covington, KY)
- …programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; ... activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. +… more