- Molina Healthcare (OH)
- **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement ... 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
- Molina Healthcare (Cincinnati, OH)
- …Extensive knowledge in health insurance + Knowledge of enrollment files, including extracts + Program Manager experience + Sr . Business or System Analyst ... remove hurdles. This is a hybrid role that requires Program Management, System Analyst and Sr . Business...units + Strong business knowledge related to Medicaid and Medicare lines of business + Reviews enrollment issue trends… 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
- Cardinal Health (Columbus, OH)
- …receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **_Responsibilities_** The Case ... Manager supports patient access to therapy through Reimbursement Support...therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is… more
- CVS Health (Columbus, OH)
- …more compassionate. And we do it all with heart, each and every day. **Position Summary** Senior Manager - Vendor Data Management is a high impact role, you will ... years of management consulting experience or 5+ years of Medicare or Medicaid benefit and financial analytics experience required....for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Columbus, OH)
- …compliance, financial viability, performance, and alignment to organizational goals. The Senior Manager will also develop and implement standardized processes ... Primary responsibilities include drafting, managing, and overseeing dental Medicaid and Medicare contracts across existing and new markets. This role involves… more
- Cardinal Health (Columbus, OH)
- …can get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through ... patient support services in accordance with the program business rules and HIPAA regulations. This role involves care coordination, insurance verification and… more
- CVS Health (Columbus, OH)
- …next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, conduct high-level ... and developing yourself and others) skills **Required Qualifications** * Commercial, Medicare , and/or Medicaid knowledge * 5+ years related experience, proven and… more
- CVS Health (Columbus, OH)
- …And we do it all with heart, each and every day. **Position Summary** The Senior Manager , Dental Business Consultant is an individual contributor role with the ... 7+ years of provider contracting experience * Knowledge of Medicare and Medicaid programs. * Ability to travel nationally...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Humana (Columbus, OH)
- …the IT supply base, alongside run-the-business initiatives). As the IT Procurement Lead ( Senior Category Manager ), you will lead the development of category ... unit project implementations. + Drive corporate compliance to the preferred-supplier program via end-user change management and communications programs. + Work… more
- System One (Dayton, OH)
- …compliance to IMO Governance audit requirements + Escalate issues to Business Owner, Program Manager , and IMO Leadership as applicable + Maintain project ... Title: Project Manager ALTA is supporting a 6-month contract opportunity...and commercial enterprises across the United States, specializing in Program & Project Management, Application Development, Cybersecurity, Data &… more
- Intermountain Health (Columbus, OH)
- … Medicare COB file processes, Medicare compliance, annual Medicare implementation, experience with program audit universes, FIR transactions, and ... payroll, hiring, employee relations, and staff mentoring. May represent department in manager absence. + Specific skills and an understanding of Part D plan… more
- Humana (Columbus, OH)
- …first Humana's Enterprise Information Protection department is seeking an experienced IT Program Manager to drive strategic initiatives that safeguard the ... cybersecurity programs, ensuring alignment with organizational security strategies. The IT Program Manager will collaborate closely with leaders to develop… more
- Trinity Health (Columbus, OH)
- …on day one + Generous paid time off programs + Employee recognition incentive program + Tuition/professional development reimbursement + Discounted tuition ... to work remotely. **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare … more
- CVS Health (Columbus, OH)
- …skills and development needs. + Assess training needs and collaborate with the SIU Sr . Manager to create development plans for team members. + Develop and ... compliance with contractual requirements. + Coordinate and collaborate with compliance and senior leadership to align on program integrity initiatives. +… more
- Cleveland Clinic (Cleveland, OH)
- …the most respected healthcare organizations in the world. As an Accreditation Program Manager , you will coordinate the hospital accreditation activities, ensure ... continuous readiness for surveys and work alongside senior leadership to facilitate a culture of continuous patient...(TJC), Ohio Department of Health (ODH) and Center for Medicare and Medicaid Services (CMS). + Act as the… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely ... Subject Matter Expertise in their areas of focus (Affordable Care Act, Medicare , Medicaid, Corporate Compliance, Compliance Assessment or Services etc.) + Develop… more
- Gentiva (Jackson, OH)
- …in **Jackson, OH.** You will report directly to the Executive Director, Administrator, or Senior Patient Care Manager . You will be responsible for maintaining a ... high performing hospice program including managing, overseeing, and directing patient care activities to ensure the delivery of quality patient care. This role is… more
- Humana (Columbus, OH)
- …and help us put health first** The IT Infrastructure Procurement Category Manager will report directly into the Director of IT Infrastructure Procurement and ... to drive enterprise-wide value. The IT **Infrastructure** Procurement Category Manager investigates available products, evaluates and recommends products based on… more
- CenterWell (Columbus, OH)
- …Kentucky, Tennessee, Louisiana, and more. The PCO has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and ... outcomes **Required Qualifications** + Expertise in value-based care, especially Medicare Advantage, with familiarity of HEDIS/STARS, medical risk adjustment, and… more