- Molina Healthcare (Cleveland, OH)
- …payment integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management ... + 3-5 years in Managed Care with emphasis on Managed Care Operations **Preferred License, Certification, Association** + PMP, CAPM, PMI-ACP, PMI-PBA… more
- Deloitte (Cleveland, OH)
- ServiceNow Senior Manager - Consulting Managed Services Enterprise Operations as a Service provides multi-year managed service contracts to support ... and transformative business changes through five key services: SAP Operations , Oracle Operations , IT Operations ,...Deloitte is where ambition meets opportunity. As a Deloitte Senior Manager, you will have the opportunity to lead… more
- Molina Healthcare (Cleveland, OH)
- …+ 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare ... DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and… more
- Molina Healthcare (Cleveland, OH)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...4 years of experience in previous roles in a managed care organization, health insurance or directly… more
- Molina Healthcare (Cleveland, OH)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... with multiple types of business data. May be internal operations -focused or external client-focused. **KNOWLEDGE/SKILLS/ABILITIES** + Elicit requirements using… more
- Molina Healthcare (Cleveland, OH)
- …health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with retrieving specified ... BI, and/or Tableau and data management. * Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures,… more
- PNC (Brecksville, OH)
- …Manager Lead you will have an exciting opportunity to work as a senior Data & Transformation lead within Retail Lending Card Modernization organization. In this ... * Provide oversight to ensure legacy coexistence and phased adoption are managed with minimal disruption * Communicate adoption progress, risks and business value… more
- Molina Healthcare (Cleveland, OH)
- …Qualifications** + At least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...of changes that impact the product. + Engages with operations leadership and Plan Support functions to review compliance-based… more
- PNC (Cleveland, OH)
- …that impacts how digital information is processed and working capital is managed . As a leader in digital payment transformation, PNC Treasury Management (TM) ... their organization. The Treasury Management platform helps clients optimize their financial operations by: + Offering a robust set of traditional and emerging… more
- The Cigna Group (Independence, OH)
- …+ Intimate understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models. + Team player with ... with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and… more
- The Cigna Group (Independence, OH)
- …relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with ... of the Provider Contracting Team and reports to the Provider Contracting Senior Manager. This role assists in developing the strategic direction and management… more