- Public Consulting Group (Columbus, OH)
- …(CMS) and the new streamlined modular certification (SMC) and outcomes-based certification (OBC). Our ideal Medicaid Consultant will provide oversight ... changing, and PCG is at the forefront. We are looking for an experienced Medicaid Consultant to join our team and help lead our growth efforts. Deep Medicaid… more
- HealthEdge Software Inc (Columbus, OH)
- **Overview** **Overview:** The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting ... products (from basic to advanced features/functionality), payment methodologies/policies (Medicare, Medicaid , and commercial), payment integrity, and healthcare plan operations… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state.Normal ... Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan,… more
- CVS Health (Columbus, OH)
- …Medicare/ Medicaid populations* MCG experience* Managed care experience* UM Certification * MedCompass Education * Minimum of an Associate's Degree in Nursing* ... personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan (PA ISNP) Scheduled : ... to work in multiple IT platforms/systemPreferred Qualifications - Knowledge of Medicare/ Medicaid - Utilization Review experience preferred - Managed care experience… more
- CVS Health (Columbus, OH)
- …& utilization management experience - Outpatient Clinical experience - Knowledge of Medicare/ Medicaid - Managed care (MCO) experience - Med Compass experience - ... CM/UM Certification Education Associates Degree required BSN preferred Pay Range The typical pay range for this role is: $29.10 - $62.31 This pay range represents… more
- Elevance Health (Mason, OH)
- …Amerigroup, is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services ... to Medicaid plans in partnership with blue cross blue shield...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- Elevance Health (Mason, OH)
- …Amerigroup, is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services ... to Medicaid plans in partnership with blue cross blue shield...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- Cleveland Clinic (Garfield Heights, OH)
- …data and participates in improvement strategy development. + Acts as a consultant in educating and evaluating clinical and support department staff regarding quality ... + Certified Patient Safety Professional (CPPS) + Healthcare Accreditation Certification Program (HACP) or Certified Joint Commission Professional (CJCP) +… more
- Cleveland Clinic (Akron, OH)
- …data and participates in improvement strategy development. + Acts as a consultant in educating and evaluating clinical and support department staff regarding quality ... Nurse Preferred. + Other preferred certifications: + Healthcare Accreditation Certification Program (HACP) or Certified Joint Commission Professional (CJCP) +… more
- Cleveland Clinic (Akron, OH)
- …strategies and applies structured problem-solving approaches. + Acts as a consultant in educating and evaluating clinical and support department staff regarding ... + Certified Professional in Healthcare Quality (CPHQ) + Healthcare Accreditation Certification Program (HACP) or Certified Joint Commission Professional (CJCP) +… more
- Cleveland Clinic (Cleveland, OH)
- …data and participates in improvement strategy development. + Acts as a consultant in educating and evaluating clinical and support department staff regarding quality ... + Certified Patient Safety Professional (CPPS) + Healthcare Accreditation Certification Program (HACP) or Certified Joint Commission Professional (CJCP) +… more
- Cleveland Clinic (Garfield Heights, OH)
- …Joint Commission (TJC), Ohio Department of Health (ODH) and Center for Medicare and Medicaid Services (CMS). + Acts as the primary resource for staff to facilitate ... overall operations of programs. + Acts as a consultant to departments/institutes for all aspects of TJC and other regulatory agencies. + Educates and disseminates… more