• Senior Medicaid & Medicare

    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
    OhioHealth (06/07/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Columbus, OH)
    Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare more
    Elevance Health (05/30/25)
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  • Senior Provider Engagement Professional-1-1

    Humana (Akron, OH)
    …to provide end to end provider experience as a member of our Medicaid team. The Senior Provider Engagement Professional develops and grows positive, ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
    Humana (06/05/25)
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  • Senior /Therapy Access Manager (Ohio…

    United Therapeutics (OH)
    …industry experience and 1+ years of experience in Market Access and Field Reimbursement supporting specialty products + Senior TAM - Bachelor's Degree with ... develop and implement plans that optimize patient access and reimbursement . You will have a strong understanding of essential...of medical insurance terminology + Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and… more
    United Therapeutics (05/10/25)
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  • Bilingual Senior Telesales Agent (Tagalog)

    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. ... part of our caring community and help us put health first** The Senior Telesales Agent conducts selling activities related to inbound calls inquiring about… more
    Humana (05/13/25)
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  • Senior Case Manager

    Cardinal Health (Columbus, OH)
    …insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare , Medicaid , Managed Care, and ... get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient… more
    Cardinal Health (04/29/25)
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  • Facility Coding Inpatient Senior Coder

    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 ... your abilities - you belong at Banner Health. Looking for a motivated, experienced ** Senior Complex Inpatient Facility | Acute Care | HIMS Coder -Remote | Medical… more
    Banner Health (05/25/25)
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  • Physician Coding Senior Coder Surgical…

    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 ... communities we serve. As a **f** **ully** **remote Physician Coding Surgical Pediatric Senior Coder** you will be coding Surgical procedures for Pediatric team. This… more
    Banner Health (05/23/25)
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  • Senior Coordinator, Individualized Care

    Cardinal Health (Columbus, OH)
    …investigations, prior authorizations, and appeals, preferred (2+ years) + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and ... go. **Accountabilities** The Case Manager supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and… more
    Cardinal Health (06/04/25)
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  • VP, Network Mgmt & Ops (Ohio Health Plan)

    Molina Healthcare (Akron, OH)
    …in Business, Health Administration, or related field. **Preferred Experience** Experience with Medicaid and Medicare managed care plans. To all current Molina ... Provider Network Management and Operations Department. Works with staff and senior management to develop and implement provider contracting and service strategies… more
    Molina Healthcare (04/23/25)
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  • VP, Revenue Cycle Management and Payer Strategy

    Cardinal Health (Columbus, OH)
    …and change management initiatives. + Thorough knowledge of commercial managed care, Medicaid , and Medicare contract payment terms, healthcare finance concepts ... VP, Revenue and Payor Operations **Location** Nationwide, US **Position Summary** Senior executive leader responsible for leading all aspects of Navista's Physician… more
    Cardinal Health (05/17/25)
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  • Registered Nurse (RN), Mobile MDS Coordinator

    CommuniCare Health Services Corporate (Cincinnati, OH)
    …Current RN license in Ohio + At least 2 years of experience with Federal Medicare / Medicaid and Managed Care reimbursement system management in working with ... Term Care and MDS experience. Multi-facility MDS experience or Senior MDS experience preferred. The Mobile MDS Coordinator will...expertise in the area of specific federal and state reimbursement systems About Us A family-owned company, we have… more
    CommuniCare Health Services Corporate (05/30/25)
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  • Hospice Clinical Manager RN - Patient Care Manager

    Gentiva (Zanesville, OH)
    …and practice, including industry standards, regulations, and best practices (ie, Medicare , Medicaid , JCAHO, ACHC), company policies/procedures, and understanding ... the community. You will report directly to the Executive Director, Administrator, or Senior Patient Care Manager. You will be responsible for maintaining a high… more
    Gentiva (06/03/25)
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  • Hospice RN Patient Care Manager, Full-Time $7,500…

    Gentiva (Lucasville, OH)
    …and practice, including industry standards, regulations, and best practices (ie, Medicare , Medicaid , JCAHO, ACHC), company policies/procedures, and understanding ... will report directly to the Executive Director, Administrator, or Senior Patient Care Manager. You will be responsible for...+ Online classes with flexible start dates + Tuition reimbursement + Company paid life and long-term disability insurance… more
    Gentiva (04/15/25)
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  • Facility Coding Inpatient Complex Coder

    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
    Banner Health (05/24/25)
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  • Safety Quality Patient Experience Specialist II

    Cleveland Clinic (Mayfield Heights, OH)
    …working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid : Government agency that provides reimbursement for accredited trainees) surveys ... the organization. + Build relationships with project teams, middle management, and senior sponsors. + Coach smaller improvement teams to success with their quality… more
    Cleveland Clinic (05/08/25)
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