• Senior Medicaid & Medicare

    OhioHealth (Columbus, OH)
    …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
    OhioHealth (06/07/25)
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  • Medicaid Provider Hospital…

    Humana (Columbus, OH)
    …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG,… more
    Humana (07/09/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Columbus, OH)
    Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare more
    Elevance Health (07/03/25)
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  • Senior Analyst, Medical Economics - REMOTE

    Molina Healthcare (Columbus, OH)
    …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare… more
    Molina Healthcare (07/10/25)
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  • Bilingual Senior Telesales Agent (French)

    Humana (Columbus, OH)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... part of our caring community and help us put health first** The Senior Telesales Agent conducts selling activities related to inbound calls inquiring about… more
    Humana (07/02/25)
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  • Provider Engagement Professional - Behavioral…

    Humana (Columbus, OH)
    …to provide end to end provider experience as a member of our Medicaid team. The Senior Provider Engagement Professional develops and grows positive, ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
    Humana (07/04/25)
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  • Coordinator - Appeals & Grievances - MediGold…

    Trinity Health (Columbus, OH)
    …Judge (ALJ) Hearings. + Prepares and reviews data universes for the Centers for Medicare and Medicaid Services (CMS) audits. + Participates in regular monitoring ... **Shift:** **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other … more
    Trinity Health (06/11/25)
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  • VP, National Provider Network Management

    Humana (Columbus, OH)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... teams in support of Humana's Insurance Business. This position reports to the Senior Vice President, Provider Experience and will lead an organization of 300+… more
    Humana (07/04/25)
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  • VP, Network Mgmt & Ops (Ohio Health Plan)

    Molina Healthcare (Columbus, OH)
    …in Business, Health Administration, or related field. **Preferred Experience** Experience with Medicaid and Medicare managed care plans. \#PJHPO \#LI-AC1 To all ... Provider Network Management and Operations Department. Works with staff and senior management to develop and implement provider contracting and service strategies… more
    Molina Healthcare (04/23/25)
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  • VP, Revenue Cycle Management and Payer Strategy

    Cardinal Health (Columbus, OH)
    …and change management initiatives. + Thorough knowledge of commercial managed care, Medicaid , and Medicare contract payment terms, healthcare finance concepts ... VP, Revenue and Payor Operations **Location** Nationwide, US **Position Summary** Senior executive leader responsible for leading all aspects of Navista's Physician… more
    Cardinal Health (05/17/25)
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  • Director II Provider Economics - Value-Based…

    Elevance Health (Columbus, OH)
    …* Use financial modeling and forecasting to support the design of new provider reimbursement methodologies across Medicare , Medicaid , and Commercial lines of ... performance, affordability, and patient outcomes by developing and optimizing data-driven reimbursement models, especially within the specialty care space. **How you… more
    Elevance Health (07/04/25)
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