- Molina Healthcare (Cleveland, 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
- Molina Healthcare (Cleveland, 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
- Elevance Health (Independence, 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
- 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
- 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 (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