- 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 (Dayton, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to… more
- Elevance Health (Mason, 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
- 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
- Molina Healthcare (OH)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare… 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 ... coding experience in Hematology & Surgical Oncology and/or Radiology Oncology. This Senior Complex Coder will be supporting very busy providers/surgeons and is very… more
- Cardinal Health (Columbus, OH)
- …preferred + Understanding of managed care contracts and fee schedules, including Medicare and Medicaid preferred + Experience with computerized billing software ... requirements and accounts assigned + Works closely with insurance carriers for reimbursement requirements to ensure payment + Reviews outstanding AR accounts and… 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
- Molina Healthcare (OH)
- …adequacy, and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct ... reimbursement models in concert with direct management and senior leadership/management. * Communicates new strategies to corporate provider network leadership… more
- Molina Healthcare (Dayton, OH)
- …in Business, Health Administration, or related field. **Preferred Experience** Experience with Medicaid and Medicare managed care plans. \#PJHPO \#LI-AC1 To all ... Provider Network Management and Operations Department. Works with staff and senior management to develop and implement provider contracting and service strategies… more
- Humana (Dublin, OH)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives + Proven planning, preparation and presenting… more
- Cardinal Health (Columbus, OH)
- …and/or hospital facility fee coding and auditing. + Expert-level knowledge of Medicare and Medicaid documentation and coding rules and guidelines; ... billing standards; communication of audit results to physicians, physician leadership, senior leadership, management, and staff; physician and coder education; 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
- 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
- Cardinal Health (Columbus, OH)
- …preferred. + Strong understanding of medical billing practices, payer guidelines, and reimbursement methodologies (commercial, Medicare , Medicaid ). + Proven ... recommend and implement preventive measures. + Prepare and present reports to senior leadership on collection performance, trends, and areas for improvement. +… more
- Prime Therapeutics (Columbus, OH)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance programs,… more