- Merck & Co. (Toledo, OH)
- Job DescriptionField Access ManagerThe Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals (HCPs) ... reimbursement issues, and support patient assistance programs, all while ensuring compliance with healthcare regulations.The FAM role is a remote/field-based role… more
- Lundbeck (Akron, OH)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/ Compliance ... to stakeholders in the primary care and neurology settings. As an Account Manager , you lead the promotion of our psychiatry portfolio, executing sales and marketing… more
- Medical Mutual of Ohio (OH)
- …responsible for leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage ... **Responsibilities:** + Manages the implementation and operation of the Medical Mutual Medicare Compliance Program. + Serves as Medical Mutual's Medicare … more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Cardinal Health (Columbus, OH)
- …trains employees across the organization, and conducts investigations to resolve ethics and compliance issues. ** Compliance Audit Manager ** Reporting to the ... the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff.… more
- Humana (Columbus, OH)
- …for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of Medicare ... and train a team of sales individuals. The Senior Manager , Medicare Sales, must have a solid...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Merck (Columbus, OH)
- **Job Description** Field Access Manager The Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals ... reimbursement issues, and support patient assistance programs, all while ensuring compliance with healthcare regulations. The FAM role is a remote/field-based role… more
- Humana (Dayton, OH)
- …health first** Humana Healthy Horizons in Ohio is seeking a RN Field Care Manager 2 with Maternity, L&D, Mother Baby expertise. They will assess and evaluate ... member's needs to achieve and/or maintain optimal wellness. The Field Care Manager will connect members/families with resources appropriate for their care and… more
- Humana (Columbus, OH)
- …of the business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare , Medicaid, and/or and Group ... community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies,...advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …models. The Manager is accountable for the successful execution and compliance of assigned value-based payment programs, serving as the subject matter expert and ... Function/General Purpose of Position** Reporting to the System Director, the Manager of Government Payment Programs provides operational leadership and oversight of… more
- CVS Health (Columbus, OH)
- …an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, ... conditions. The CMS collaborates closely with the Registered Nurse Care Manager , Care Coordinator, Social Worker, and other interdisciplinary care team participants… more
- Gentiva (Dayton, OH)
- …care, and developing staff to uphold the highest standards of patient care and regulatory compliance . **As a Hospice Patient Care Manager , You Will:** + O versee ... + Demonstrated ability to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid, JCAHO, ACHC) + Knowledge and compassion… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …operational excellence. **Primary Function/General Purpose of Position** The Program Manager , Population Health Finance & Performance Analytics provides centralized ... key member of the Population Health finance analytics team, the Program Manager delivers data-driven insights that enable leadership to make informed decisions that… more
- Cognizant (Columbus, OH)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA), ensuring compliance with CMS, ACA, and ... **Product Owner Health Sciences, Consulting Manager ** **About the Role:** As a Product Owner...team and work collaboratively with business stakeholders, sales, marketing, compliance , IT, and clients. **In this role, you will:**… more
- Cognizant (Columbus, OH)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA), ensuring compliance with CMS, ACA, and ... Sales & Enrollment team and work collaboratively with business stakeholders, sales, marketing, compliance , IT, and clients. **In this role, you will** . Define and… more
- CVS Health (Columbus, OH)
- …heart, each and every day. **Position Summary** The Vendor Account Senior Manager role encompasses ownership of managing relationships with third-party vendors to ... ensure optimal performance, compliance , contracting and alignment with organizational goals to ensure...(eg, CPM, CPSM) is a plus. + Commercial and Medicare Line of Business experience preferred. **Education** + Bachelor's… more
- Flynn Restaurant Group (Independence, OH)
- …Ensure compliance with federal and state regulatory requirements, including Medicare reporting. + Oversee vendor partnerships (eg, defense firms, nurse case ... Fitness Group) is seeking an experienced and strategic Workers' Compensation Claims Manager to lead the administration of its national workers' compensation program.… more
- Molina Healthcare (Akron, OH)
- …implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist, Quality Interventions/ QI ... of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Implements key quality strategies, which may include initiation… more
- Capgemini (Cincinnati, OH)
- …the job:** Job role responsibilities of **Program Manager / Sr Project Manager ** - Markets and Growth portfolio Medicare Advantage/ DSNP/ Medicaid or ... of Pharmacy Benefits Experience in working with Plan and Pharmacy Benefits Manager Setting up Pharmacy call center Pharmacy member materials Provider Materials State… more
- OhioHealth (Marion, OH)
- …role is a subject matter expert, with current knowledge of policies, procedures, compliance , fair market value acumen and state & federal rules and regulations. The ... is necessary and must be maintained to facilitate the success of the compliance initiatives aligned with physician contracting. The purpose of this position is to:… more
