- Molina Healthcare (Columbus, OH)
- …payment integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management ... + 3-5 years in Managed Care with emphasis on Managed Care Operations **Preferred License, Certification, Association** + PMP, CAPM, PMI-ACP, PMI-PBA… more
- JPMorgan Chase (Columbus, OH)
- …cross Line Of Business requests to include exposure to customers that are managed by units outside of the family responsibility area. + Coordinate all administrative ... meet employee needs, based on eligibility. These benefits include comprehensive health care coverage, on-site health and wellness centers, a retirement savings plan,… more
- Molina Healthcare (Cincinnati, OH)
- …+ 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare ... DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and… more
- Hilton (Columbus, OH)
- …hotels to our ever\-growing portfolio\! **What will I be doing?** As a Senior Director Management Contract Services, you will partner with owners and investors to ... grow Hilton's managed and franchised hotel portfolio\. On the Owner Relations...settle disputes, and addressing owner\-reported concerns by communicating with operations teams and responding promptly\. + Manage the entire… more
- Molina Healthcare (OH)
- …facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Proficiency with Microsoft ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Molina Healthcare (Cincinnati, OH)
- …analysis and transformation, specifically in processing healthcare claims data and supporting managed care reporting needs + Experience using **Power BI** for ... role supporting **utilization management, population health, or quality improvement within a Managed Care Organization (MCO)** + Experience working directly with… more
- Robert Half (Cincinnati, OH)
- …independent and locally owned Member Firms provide clients with consulting and managed solutions in finance, technology, operations , data, analytics, digital, ... JOB REQUISITION Senior Talent Manager LOCATION AMERICAS DELIVERY CENTER ADDITIONAL...is a passion. We lean into our mission: We Care . We Collaborate. We Deliver . At every level,… more
- Banner Health (OH)
- …Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options ... improving to make Banner Health the best place to work and receive care . Are you an experienced **Hematology Oncology Physician Coder** looking for the opportunity… more
- Humana (Columbus, OH)
- …as Computer Science, Mathematics or Statistics and/or related field + Healthcare or managed care experience + Experience performing data management, mining, and ... we deliver world class solutions that address inefficiencies in the health care . The Senior Cognitive/Machine Learning Professional collaborates with analytic… 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
- Sherwin-Williams (Cleveland, OH)
- ABOUT THE ROLE: + The Senior Database Engineer role designs and develops robust and reliable database management systems that are secure, reliable, meet the ... technical platforms using modern tooling, build systems and processes for operations and maintenance that facilitate production needs and speed application… more
- Western Digital (Columbus, OH)
- …needs * Facilitate technical requirements and maintain well-defined roadmaps with senior stakeholders **Legal Technology Leadership** * Serve as in-house expert on ... Change Management** * Continuously identify automation and innovation opportunities in legal operations * Track system usage, impact, and satisfaction metrics * Lead… more
- Virtual Service Operations (Dayton, OH)
- Cleared Senior Information Systems Security Engineer (ISSE) L4 * DAYTON, OH (http://maps.google.com/maps?q=DAYTON+OH+USA) Description Are you looking to take the ... innovative solutions to support ongoing Cyber Threat and Defensive Operations . + Provide functional expertise and technical recommendations to...More About VSO: VSO is a hybrid cloud and managed services consulting firm. Much of VSO's success can… more
- Brookfield Properties (Cleveland, OH)
- …team, we encourage you to apply. Job Description Product Summary The Senior Director, Product Management at Brookfield Properties Multifamily is a strategic ... development, and performance of critical technology products that support multifamily operations . Leading a technical team, this leader manages the full product… more
- Molina Healthcare (Cleveland, OH)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... with multiple types of business data. May be internal operations -focused or external client-focused. **KNOWLEDGE/SKILLS/ABILITIES** + Elicit requirements using… more
- Molina Healthcare (Cleveland, OH)
- …in billing, claims, encounters, and data analysis + 5 years or more of managed care experience + Knowledge of advanced data analysis techniques + Skilled ... with preparing portions of materials and information for Monthly Governance and Operations Reviews + Performs root cause analysis of claims and encounter data… more
- Highmark Health (Columbus, OH)
- …various complex potential claims with emphasis on controlling losses through effective managed care . This includes following a departmental claim checklist to ... the accuracy of client reports submitted to the organization, efficiency of claim operations , and adequacy of systems and procedures. + Approves claim payments on… more
- Centene Corporation (Columbus, OH)
- …**Education/Experience:** Current state RN license preferred. Previous experience in a managed care organization strongly preferred. 3+ years of leadership ... The Vice President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies that drive measurable… more
- CenterWell (Columbus, OH)
- …+ Previous Commercial, Medicare and/or Medicaid experience + Previous clinical experience in managed care **Additional Information** + This is a remote position ... and help us put health first** The Staff Specialty Operations Pharmacist applies clinical and operational knowledge to ensure...at the center. As the nation's largest provider of senior -focused primary care , one of the largest… more
- CVS Health (OH)
- …of the time as required to meet business needs. **Required Qualifications** 3+ years of managed care Pharmacist experience and/or 1 year of Managed Care ... team, pharmacists, medical directors, CMO as well as other senior health plan leaders. The Health Plan Clinical Advisor...- Demonstrated experience in a client-facing role within the managed care environment - Demonstrated understanding of… more