- Molina Healthcare (Columbus, OH)
- …of knowledge although they may have technical team members. **Expanded Scope:** The Senior Project Manager for Claims Operations drives complex, ... & Regulatory Acumen (Healthcare/ Claims )** + Deep understanding of claims lifecycle, EDI transactions, payment integrity, provider data, appeals/grievances,… more
- CVS Health (Columbus, OH)
- …strategic initiatives, and partnering to elevate insights that can positively impact provider experience. The Senior Manager , accounts receivable ... to help review, understand, and identify process improvements across key provider journeys including self-service / digital transactions, claims management,… more
- Zurich NA (Columbus, OH)
- …**This role will be filled at either the** ** Senior or AVP Claims Professional** **Level.** **The hiring manager will determine the appropriate level based ... + Microsoft Office experience + Knowledge of insurance regulations, markets, and products OR Senior Claims Professional: + Bachelor's Degree and 6 or more years… more
- CVS Health (Columbus, OH)
- …to solution design and architecture discussions, collaborating with architects and senior engineers. + Provide input on technical feasibility, performance ... project work that crosses many Aetna Technology domains/applications. A Release Manager in this area requires substantial business and systems knowledge along… more
- CVS Health (Columbus, OH)
- …providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and ... financial goals and cost initiatives. Collaborates cross-functionally to develop provider compensation and pricing strategies and manages contracts through language… more
- WelbeHealth (Columbus, OH)
- … claims with errors back to the claims team for corrections + Provide feedback to the Oversight & Monitoring Manager on claims processing errors, ... senior care by providing an all-inclusive healthcare option (PACE) to the most vulnerable senior population while serving as a care provider and care plan to… more
- WelbeHealth (Columbus, OH)
- … senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, while serving as a care provider and care plan to those ... pivotal role in ensuring timely and efficient processing of claims for our contracted specialty provider partners....procedures, or other established quality standards + Work alongside manager to establish and maintain claims processing… more
- Elevance Health (Mason, OH)
- ** Provider Contract Cost of Care Analyst Senior ** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Provider Contract Cost of Care Analyst Senior **...providing analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims… more
- Danaher Corporation (Cincinnati, OH)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position is a provider / customer ... responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of...this role, you will have the opportunity to: + Provide education to healthcare providers, lab professionals, office staff… more
- RxBenefits (Columbus, OH)
- In this multi-disciplinary, cross functional role, the Senior Manager , Pharmacy Pricing will report to the Director, Pharmacy Pricing & Analytics. The Senior ... file requests, current account RFPs, and competing PBM comparisons. The Manager also assists with resolving client issues involving performance discrepancies and… more
- Stantec (Cincinnati, OH)
- Stantec's Program Management Construction Management (PMCM) Group is seeking a Senior Construction Manager to work on large, complex wastewater projects with ... construction values exceeding $500M over a 10-year period. The Senior Construction Manager will serve as a...including scopes of work. - Serve as owner's contract manager in the resolution of all claims … more
- Turner & Townsend (Columbus, OH)
- …markets around the world. **Job Description** **Turner & Townsend** is looking for a ** Senior Risk Manager ** to join our growing team. The ideal individual will ... claims management. + Carry out assessment of contractual claims in accordance with the contract. + Provide... claims in accordance with the contract. + Provide strategic and contractual advice on disputes and related… more
- The Goodyear Tire & Rubber Company (Akron, OH)
- As the Senior Manager of Creative Copy, you will be the voice behind Goodyear's brand portfolio, leading the development of messaging systems, brand narratives, ... film and digital to retail and partner communications. You'll manage a Senior Copywriter and collaborate closely with the Creative director of Design to… more
- Turner & Townsend (Columbus, OH)
- …around the world. **Job Description** **Turner & Townsend** are seeking an experienced ** Senior ** **Project Controls Manager ** to join our team. The ideal ... a significant minority interest. Turner & Townsend and CBRE work together to provide clients with the premier programme, project and cost management offering in… more
- ABM Industries (Columbus, OH)
- …is damaged in any way and that the accident is promptly reported to the District Manager , Safety, Claims and Customer. + Looks for root causes of accidents and ... **Overview** Sr. Project Manager operates rental cars in a safe manner...when the sun's glare or direct blasts of sunlight provide additional challenges to safe vehicle operation. **Physical Demands:**… more
- Molina Healthcare (Dayton, OH)
- …cost recovery processes + Direct PM experience in Managed Care Operations ( claims , system configuration, provider data management preferred) + Demonstrated ... system development lifecycle methodologies **Knowledge:** + Experienced in working with claims and claim configuration teams to streamline adjudication and resolve… more
- The Cigna Group (Cleveland, OH)
- …an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager . This role assists in developing the strategic ... Ancillaries, and large physician groups). + Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support… more
- Insight Global (Beachwood, OH)
- …Develop and contribute to scientific manuscripts, conference presentations, and publications. o Provide clinical evidence to support marketing claims and product ... positioning. - Cross-Functional Collaboration o Work closely with product management, engineering, regulatory, and medical affairs to ensure alignment between product development and clinical evidence. o Identify clinical evidence gaps across the product… more
- OhioHealth (Mansfield, OH)
- …meetings & trial activities as delegated. 4. Liability & Casualty Insurance claims manager - 10% Reviews, investigates, & analyzes general liability incidents ... with the Risk Manager , Systems Director, and/or the General Counsel, for claims within the self-insured retention, is given authority to negotiate & settle … more
- Elevance Health (Mason, OH)
- …of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How ... **Nurse Audit Senior - Payment Integrity Complex and Clinical Audit**...fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing + Correlates review… more