- Molina Healthcare (Akron, OH)
- …and distribute standard reports on schedule + Position reports to AVP, Payment Integrity Analytics **JOB QUALIFICATIONS** **REQUIRED EDUCATION** : + Bachelor's ... and/or Project management experience. + Managed Care experience - **_specifically within Payment Integrity , Claims Payment , Provider Relations Experience_**… more
- Molina Healthcare (Akron, OH)
- …work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job ... of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Leads and… more
- Molina Healthcare (Akron, OH)
- …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- BrightSpring Health Services (Canton, OH)
- Our Company ResCare Community Living Overview The Program Manager is responsible for overseeing the daily operations and service delivery of residential and ... values. Working closely with the Executive Director and leadership team, the Program Manager leads staff, coordinates individualized supports, ensures quality… more
- Molina Healthcare (Akron, OH)
- …workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity . + Technology Enablement: Oversee requirements, ... (Healthcare/Claims)** + Deep understanding of claims lifecycle, EDI transactions, payment integrity , provider data, appeals/grievances, and audit/compliance… more
- Molina Healthcare (Akron, OH)
- …Level of Care, Inpatient Readmission, and any opportunity identified by the Payment Integrity analytical team; requires decision making pertinent to clinical ... database + Provides supporting documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by… more
- EMCOR Group (Barberton, OH)
- …clients significant financial strength, unmatched bonding capability, an award-winning safety program , and large-scale purchasing power. With 16 locations and over ... clients regarding outstanding payments. + Resolves high volume collections by examining customer payment plans, payment history, credit line + Locate, code, and… more
- Huntington National Bank (Akron, OH)
- …Mainframe teams to complete application installs/decommissions + Work with Portfolio Manager deliver IAM projects and key milestones. + Consult with business ... (AD), public key infrastructure (PKI), privileged accounts and integration application program interface (API) capabilities. + Track record acting with integrity… more