- Staffing Solutions Organization (Columbus, OH)
- …diverse workforce, which is a reflection of our clients and the people they serve. ** Onsite Reviewer (OH Department of Medicaid ) in Ohio** **(Location - ... overarching responsibility for this position is to ensure Ohio Medicaid providers are providing a legitimate service,...a comprehensive checklist approved by the Ohio Department of Medicaid (ODM). The Onsite Reviewer … more
- Evolent (Columbus, OH)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact… more
- Evolent (Columbus, OH)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet...medical necessity guidelines, as well as other requests when providers , clients, or state laws require specialty reviews to… more
- Evolent (Columbus, OH)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet...necessity guidelines, as well as other imaging requests when providers , clients, or state laws require specialty reviews to… more
- Evolent (Columbus, OH)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. ... Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially...necessity guidelines, as well as other imaging requests when providers , clients, or state laws require specialty reviews to… more
- Highmark Health (Columbus, OH)
- …and report improper coordination of benefit billing practices through paid clams review . + Participate as pharmacy representative in onsite member appeals ... and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal… more
- Cuyahoga County Board of Developmental Disabilities (Cleveland, OH)
- …in choosing providers as needed. + Assist with enrollment onto Medicaid waivers as appropriate. Complete all related paperwork accurately and in a timely ... obtain services and supports. Implement an ongoing system of review . The nature of work will include, but is...as needed. + Establish and maintain contact with service providers and natural supports as necessary to ensure that… more
- ChenMed (Cincinnati, OH)
- …inspire others with your kindness and joy? We're different than most primary care providers . We're rapidly expanding and we need great people to join our team. The ... and/or could contribute to future hospitalizations. + Assess patients for Medicaid criteria and assist with application process as needed. + Assessments… more
- Elevance Health (Mason, OH)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
