- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Senior Payment Integrity Professional uses technology and data mining, detects ... to the investigations of fraud waste and our financial recovery. The Senior Payment Integrity Professional work assignments involve moderately complex… more
- Elevance Health (Mason, OH)
- **Nurse Audit Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the ... considered for employment, unless an accommodation is granted as required by law. **Carelon Payment Integrity ** is a proud member of the Elevance Health family… more
- Molina Healthcare (OH)
- …insight to Molina's culture, Mission and Values. **KNOWLEDGE, SKILLS & ABILITIES** ** Payment Integrity Analytics** + Assist in analyzing large datasets to ... and analysts to conduct exploratory and diagnostic data analysis that supports payment integrity projects. + Utilize statistical analysis, machine learning… more
- Humana (Columbus, OH)
- …cost-effective approaches to minimize risk of Medicaid operations within Humana's Payment Integrity Unit. Assesses and communicates contractual obligations ... + Legal research experience + Compliance audit/readiness review experience + Payment Integrity experience **Additional Information** _Due to contractual… more
- Molina Healthcare (Columbus, OH)
- …workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity . + Technology Enablement: Oversee requirements, ... (Healthcare/Claims)** + Deep understanding of claims lifecycle, EDI transactions, payment integrity , provider data, appeals/grievances, and audit/compliance… more
- Norstella (Columbus, OH)
- Senior RWD Analytic Consultant Company: Norstella Location: Remote, United States Date Posted: Oct 24, 2025 Employment Type: Full Time Job ID: R-1541 **Description** ... UK, The Netherlands, Japan, China and India. **The Role: Senior RWD Analytic Consultant** We are currently seeking a...at the executive level. **Qualifications:** * 4+ years of professional experience working hands on with RWD (eg, open/closed… more
- Lumen (Columbus, OH)
- …the world and shape the future. **The Role** We are seeking a dynamic and versatile professional to join our team as a Project Management Sr. Lead in the Product & ... business operations + Strong documentation and experience participating operational reviews with senior leadership Boards. + Able to manage multiple priorities in a… more
- CDM Smith (Cincinnati, OH)
- **42785BR** **Requisition ID:** 42785BR **Business Unit:** IND **Job Description:** As a Senior Substation Engineer - Physical, you'll lead the design and execution ... responsible engineer in charge (EOR) for assigned projects, ensuring technical integrity and regulatory compliance. Support career development and mentoring of… more
- City National Bank (Columbus, OH)
- *MORTGAGE LOAN UNDERWRITER SENIOR * WHAT IS THE OPPORTUNITY? The role of the Underwriter III is to evaluate the credit risk against company standards and to determine ... analysis, financial statement analysis, cash flow analysis, liquidity qualification and payment calculation spreads * Reviews for stability of residency and… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …management related issues that could impact the classification, availability, or integrity of data or processes. + Highlights control breakdowns, inadequate ... Basic understanding of IT systems, infrastructure, and data privacy principles. + Professional verbal and written communication skills and the ability to communicate… more
- GovCIO (Columbus, OH)
- **Overview** GovCIO is currently hiring for a Senior Network/Systems Administrator with an active Secret clearance. This position will be located in Sterling, VA and ... software and hardware) in networked or stand-alone configurations, maintains system integrity , and upgrades systems and/or servers as required. May create and… more
- Molina Healthcare (Dayton, OH)
- …teams to streamline adjudication and resolve claim processing issues + Familiar with payment integrity and other cost recovery processes + Direct PM experience ... 5-7 years experience as a Health Insurance industry Project Management professional **Preferred Education** + Graduate Degree or equivalent combination of education… more
- Public Consulting Group (Columbus, OH)
- …the children, adults, and families they serve. Join us and use your professional skills to build stronger communities and better serve populations in need by ... of funds and banking relationships to ensure seamless processing of payment programs and associated management of issues related to payments distribution… more
- EDB (Columbus, OH)
- …for our mutual customers. This quota-carrying role requires a results-oriented professional with proven experience in partner and alliance management, sales ... AI and data platform capabilities. + Cultivate trusted relationships with senior executives and key decision-makers at partner organizations. **Proven Partner… more
- Sedgwick (New Albany, OH)
- …Workplaces in Financial Services & Insurance Disability Representative Sr. ** Senior Disability Representative - Make a Meaningful Impact** **Location:** **Hybrid ... and we're looking for experienced, compassionate professionals to join us as** ** Senior Disability Representatives** **. If you're someone who thrives in a… more
- CenterWell (Columbus, OH)
- …and make iterative improvements. + Present findings and recommendations to senior leadership through clear, data-driven storytelling. + Stay current with industry ... a team + Strong ethical standards and commitment to integrity + Adaptable and able to thrive in a...Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Home or Hybrid… more
- PNC (Strongsville, OH)
- …database performance tuning, query optimization, indexing strategies, and managing database integrity and security. * Strong leadership and team management skills, ... including mentoring technical teams, fostering professional growth, and building high-performing teams. * Deep understanding and practical application of ITIL… more
- Highmark Health (Columbus, OH)
- …process optimization across multiple analytic workstreams-such as NLP-driven decision tools, payment integrity automation, and GenAI enablement. This position is ... the resolution of day-to-day operational problems. 2. Under supervision, provide professional services as appropriate to the day-to-day operating objectives of the… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …must be comfortable communicating with technical experts, mid-level management and senior leadership. Candidates must have working knowledge of enterprise IT and ... management related issues that could impact the classification, availability, or integrity of data or processes. + Highlights control breakdowns, inadequate… more