- OhioHealth (Columbus, OH)
- …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
- Humana (Columbus, OH)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG,… more
- Humana (Columbus, OH)
- … Business Intelligence Engineer will develop and maintain expertise in complex Medicare reimbursement methodologies. This role is within the Integrated Pricing ... on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement /editing logic and Humana system logic **Use your skills… more
- Deloitte (Cleveland, OH)
- …consulting services to public sector clients + Support engagements focused on Medicaid reimbursement , including actuarial rate development across managed care ... and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie, DSH, UPL, etc.) + Experience with… more
- Danaher Corporation (Cincinnati, OH)
- …and reimbursement landscape. + Communicate regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through ... Danaher Business System (https://www.danaher.com/how-we-work/danaher-business-system) which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position… more
- Humana (Columbus, OH)
- …looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... us put health first** Humana Healthy Horizons is seeking a Senior Value-Based Programs professional who will support successful value-based provider relationships… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... customers at the center of everything it does. The Senior Learning Design Professional uses instructional design, cognitive psychology...match + Generous Paid Time Off accrual + Tuition Reimbursement + Parent Leave + Go365 perks for well-being… more
- Molina Healthcare (Akron, OH)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and… more
- Molina Healthcare (Cleveland, OH)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and… more
- Molina Healthcare (Cincinnati, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, ... programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex… more
- Banner Health (OH)
- …compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the ... information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or… more
- Centene Corporation (Columbus, OH)
- … Medicaid . + Lead population health initiatives with a strong focus on Medicaid while collaborating with partners on Medicare and Marketplace programs. + ... President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies...the direction of Centene and the Ohio Department of Medicaid . While the primary focus is on Medicaid… more
- Humana (Columbus, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and… more
- Baylor Scott & White Health (Columbus, OH)
- …and senior medical staff including denials from all payers, Medicare / Medicaid audit activities and key contract enforcement activities. + Collaborates ... to improve appeal success rates, ensure regulatory compliance and optimize reimbursement outcomes. Will lead external resources through vendor or contractor… more
- Molina Healthcare (Cleveland, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... regulatory and/or functional requirements related but not limited to coverage, reimbursement , and processing functions to support systems solutions development and… more
- Cleveland Clinic (Euclid, OH)
- …working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid : Government agency that provides reimbursement for accredited trainees) surveys ... + Build relationships with project teams, middle management, and senior sponsors. + Coach smaller improvement teams to success...Investment Plan + Investment Pension Plan (IPP) + Tuition Reimbursement + Paid Time Off (PTO) + Employee Discounts… more
- Cardinal Health (Columbus, OH)
- …of insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid , commercial insurance plans, and managed care preferred. + ... Review aging reports and work insurance accounts to ensure timely resolution and reimbursement . + Contact insurance companies via phone, portals, or email to check… more
- Molina Healthcare (Dayton, OH)
- …observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. ... manages a team of medical economics team of professionals. * Collaborates with senior level clinicians and leaders from functional areas such as finance, health care… more