- Molina Healthcare (Dayton, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (OH)
- …compassionate. And we do it all with heart, each and every day. As the Senior Manager , Aetna Medical Pharmacy, you will be accountable for leading the ... and organizational compliance with regulations related to the organization's Medicare Part B program operations. + Triage...related to the organization's Medicare Part B program operations. + Triage escalation requests to the correct… more
- Molina Healthcare (OH)
- …**Job Summary** Establish a specifically designed Operational Regulatory Oversight program that effectively prevents and/or detects violation of applicable laws ... provisions, and internal policies and procedures. * Supports the Operational Oversight Manager , Director, and team in the general development of the Operational… more
- CVS Health (OH)
- …and more compassionate. And we do it all with heart, each and every day. As a Senior Manager within the Aetna Medicare Pharmacy team, you will play a ... critical role in shaping and executing the organization's Medicare Part D formulary and product strategy. Leveraging your...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Humana (Dayton, OH)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and… more
- CVS Health (OH)
- …and more compassionate. And we do it all with heart, each and every day. As the Senior Manager , Aetna Medicare Medical Pharmacist, you will play a key role ... and execution of business strategies and programs within the Medicare Part B Pharmacy Team. You will act as...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Humana (Columbus, OH)
- …are 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...+ This role is part of Humana's Driver safety program and therefore requires an individual to have a… 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 ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- CVS Health (OH)
- …and every day. **Position Summary** We are seeking a highly skilled and experienced Senior Data Engineering Manager to lead and mentor our data engineering team ... team that is responsible for processing Claims, Revenue, and Medicare Specific files and data from 30+ payors into...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Group ... in up to a year-long on the job training program that develops knowledge and skills needed to progress.... Discusses the proposed plan and funding designs with manager . Gathers information, develops options and consults with sales/service… more
- CenterWell (Columbus, OH)
- …part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health ... outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the… more
- BAYADA Home Health Care (Cuyahoga Falls, OH)
- BAYADA Home Health Care is currently seeking an experienced health care manager to fill the position of **Associate Director** in our Cuyahoga, OH Senior Living ... industry, preferably in home health care + Knowledge of Medicare regulations, including OASIS and PPS + Knowledge of...401k with company match, direct deposit and employee assistance program + To learn more about BAYADA Benefits, click… more
- CenterWell (Columbus, OH)
- …appropriate. The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a ... services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. +… more
- Molina Healthcare (OH)
- …with organizational goals and Molina's stated commitments + Supervise the Provider Workforce Program Manager + Engages with all program stakeholders to ... **JOB DESCRIPTION** **JOB SUMMARY** : The Program Director leads strategic initiatives to enhance the...barriers in implementation and compliance to AVP, VP and senior management + Consultative role, develops business case methodologies… more
- CenterWell (Columbus, OH)
- …responsible for the medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care's (and Conviva Senior Primary Care's) Home-Based ... Care portfolio, serving the highest-need and most complex senior patients. This role will lead clinical strategy, quality improvement, and care delivery innovation… more
- CenterWell (Columbus, OH)
- …(ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + Member of the American Academy of Actuaries + ... Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and… more
- CenterWell (Solon, OH)
- …+ Primarily conduct facility visits at the physicians' request to assist program clinical team in determining eligibility. + Ensure effective communication and ... collaboration with program staff and other field sales resources via weekly...license. + Must have strong knowledge of governmental regulations, Medicare eligibility requirements, comprehensive understanding of potential care plan… more
- Molina Healthcare (Cleveland, OH)
- …skills. * Microsoft Office suite (including Excel), and applicable software program (s) proficiency. **Preferred Qualifications** * Medicare Part D and/or ... care team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...pharmacy call center team under the direction of pharmacy senior leadership. * Identifies and implements programs to improve… more
- CenterWell (Columbus, OH)
- …the delivery of home health services preferred + Working knowledge of Medicare enrollment and guidelines governing home health agencies preferred + Demonstrated ... eligible dependents + Caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more