- JEFFERSON INDUSTRIES CORPORATION (West Jefferson, OH)
- …Product Quality Planning. Our facilities support high quality product manufacturing, and we provide a timely and flexible approach to meeting the needs of our ... (SNAP). *Establish Daily, Weekly & Monthly reviews and reflections using CAPDo. COST *Supports the development and management of Weld Department budget and costs.… more
- Elevance Health (Columbus, OH)
- ** Provider Contract / Cost of Care Consultant** **Locations:** This role requires associates to be in-office **1-2** days per week, fostering collaboration ... NOTE: This position is not eligible for current or future VISA sponsorship._ The ** Provider Contract / Cost of Care Consultant** provides analytical… more
- Elevance Health (Columbus, OH)
- ** Provider Contract Cost of Care Consultant - VBC** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consultant...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Molina Healthcare (Columbus, OH)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads...department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates.… more
- Elevance Health (Columbus, OH)
- Provider Success Consultant Sr. (Ohio Market) **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... This position will require the candidate to travel to provider locations in Ohio at a minimum of 50%...at a minimum of 50% of the time. **The Care Consultant Sr.** is responsible for fostering long-term partnerships… more
- Molina Healthcare (Columbus, OH)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Columbus, OH)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- OhioHealth (Columbus, OH)
- … site goals on delivering on the value equation of quality, service, and cost efficiency, while maintaining an exceptional provider and staff culture. This role ... everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover...goals. Growth - Through the Clinical Enterprise standard processes, provide strategic and operational direction in support of the… more
- Molina Healthcare (Columbus, OH)
- …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
- Molina Healthcare (Columbus, OH)
- …goals of the department and organization. + Oversees the maintenance of all provider contract information and templates and ensures that all negotiated contracts ... and implement provider contracting and service strategies to contain unit cost , improve member access and enhance provider satisfaction with the Plan.… more
- Molina Healthcare (Columbus, OH)
- …other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) + ... Builds work breakdown structures, monitors task activities, and ensures state contract timelines are met. Monitors the project from inception through delivery.… more
- Molina Healthcare (Columbus, OH)
- …claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and ... cost containment reports and makes recommendations based on relevant...materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of… more
- Intermountain Health (Columbus, OH)
- …in care . Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved ... and training techniques. Based on medical record metrics and contract obligations, conducts patient outreach and follow up in...the efforts of providers and practice teams on office-based care delivery interventions resulting in cost of… more
- Humana (Columbus, OH)
- … efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration. The RVP ... and maintain trusted relationships with CMOs and senior executive/clinical leaders at provider and care delivery partner organizations. First and foremost, this… more
- Molina Healthcare (Columbus, OH)
- …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more
- Elevance Health (Columbus, OH)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental ... for autism and depression, and insightful analytics to improve the delivery of care . **Virtual** - This role enables associates to work virtually full-time, with the… more
- Highmark Health (Columbus, OH)
- …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
- Elevance Health (Columbus, OH)
- …service coordinator and other clinical healthcare management and interdisciplinary teams to provide care coordination support. + Manages non-clinical needs of ... is responsible for supporting the LTSS Transition Coordinator (or contracted provider ) in contributing to the components of the person-centered planning process,… more
- UMB Bank (Columbus, OH)
- …Risk, Compliance, Information Security, Finance, and Business Operations to ensure contract terms meet applicable standards and adequately protect UMB interests. You ... renewals, software license, maintenance, support, subscriptions, and/or other third-party contract commitments. This position reports to the Senior Vice President,… more
- Humana (Columbus, OH)
- …with internal stakeholders including Finance, Actuarial, Clinical, Medicare Risk Adjustment, Provider Contracting, and Provider Engagement internally + Leverages ... financial and operational performance for the region + Leads membership, financial, cost & utilization reporting at all levels + Supports Humana's Medicare Advantage… more
