- Molina Healthcare (Cleveland, OH)
- …Qualifications** + At least 6 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent ... + Provides status and updates to health plan/product team partners, senior management and stakeholders. + Communicates requirement interpretations and changes to… more
- Molina Healthcare (Cleveland, OH)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...4 years of experience in previous roles in a managed care organization, health insurance or directly… more
- Molina Healthcare (Cleveland, OH)
- …or equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT; SQL experience + Crystal Reports… more
- Molina Healthcare (Cleveland, OH)
- …health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with retrieving specified ... BI, and/or Tableau and data management. * Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures,… more
- PNC (Cleveland, OH)
- …that impacts how digital information is processed and working capital is managed . As a leader in digital payment transformation, PNC Treasury Management (TM) ... their organization. The Treasury Management platform helps clients optimize their financial operations by: + Offering a robust set of traditional and emerging… more
- Elevance Health (Independence, OH)
- …health care analytics, financial reporting, business analysis within health insurance/ managed care environment; or any combination of education and ... responsible for directing and overseeing health plan financial analysis, cost of care analytics, trend analysis, financial reporting, financial operations , and… more
- The Cigna Group (Cleveland, OH)
- …+ Intimate understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models. + Team player with ... with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and… more
- The Cigna Group (Cleveland, OH)
- …relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with ... of the Provider Contracting Team and reports to the Provider Contracting Senior Manager. This role assists in developing the strategic direction and management… more