- Battelle Memorial Institute (Columbus, OH)
- …technical leader interfaces are the program managers, contracts, finance, quality, operations , suppliers, and our customers. This engineering leadership position is ... has a thorough knowledge of contractual issues relative to the program being managed relevant to scope of the work, scheduling and subcontracts. Advises contract… more
- Molina Healthcare (Columbus, 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
- UKG (Columbus, OH)
- …you'll thrive in our fast-paced, mission-driven environment. **About the Role** As a ** Senior Sales Consultant - Managed Services** , you will serve as ... code you ship, the decisions you make, and the care you show a customer all add up to...ee+)** , helping them reimagine their HR and payroll operations through UKG's fully managed offerings. You… more
- Molina Healthcare (Columbus, 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
- Datavant (Columbus, OH)
- …sciences companies, government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a high-performing, values-driven ... realize our bold vision for healthcare. **Job Summary** The Senior Manager, Facilities at Datavant will lead all aspects...Facilities at Datavant will lead all aspects of facilities operations across our locations around the world, ensuring safe,… more
- Humana (Columbus, OH)
- …as Computer Science, Mathematics or Statistics and/or related field + Healthcare or managed care experience + Experience performing data management, mining, and ... we deliver world class solutions that address inefficiencies in the health care . The Senior Cognitive/Machine Learning Professional collaborates with analytic… more
- Molina Healthcare (Columbus, OH)
- …or equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT; SQL experience + Crystal Reports… more
- Western Digital (Columbus, OH)
- …needs * Facilitate technical requirements and maintain well-defined roadmaps with senior stakeholders **Legal Technology Leadership** * Serve as in-house expert on ... Change Management** * Continuously identify automation and innovation opportunities in legal operations * Track system usage, impact, and satisfaction metrics * Lead… more
- Molina Healthcare (Columbus, 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 (Columbus, OH)
- …in billing, claims, encounters, and data analysis + 5 years or more of managed care experience + Knowledge of advanced data analysis techniques + Skilled ... with preparing portions of materials and information for Monthly Governance and Operations Reviews + Performs root cause analysis of claims and encounter data… more
- Humana (Columbus, OH)
- …+ Lead and provide direction for our Managed Service Provider (MSP) + Lead Managed Service Provider in Operations for Azure, GCP and AWS Cloud environment + ... point) for Incident Management + Participate and develop client relationships within Operations , Business partners, Managed Service Providers and Cloud Providers… more
- Centene Corporation (Columbus, OH)
- …**Education/Experience:** Current state RN license preferred. Previous experience in a managed care organization strongly preferred. 3+ years of leadership ... The Vice President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies that drive measurable… more
- CenterWell (Columbus, OH)
- …+ Previous Commercial, Medicare and/or Medicaid experience + Previous clinical experience in managed care **Additional Information** + This is a remote position ... and help us put health first** The Staff Specialty Operations Pharmacist applies clinical and operational knowledge to ensure...at the center. As the nation's largest provider of senior -focused primary care , one of the largest… more
- CVS Health (Columbus, OH)
- …of the time as required to meet business needs. **Required Qualifications** 3+ years of managed care Pharmacist experience and/or 1 year of Managed Care ... team, pharmacists, medical directors, CMO as well as other senior health plan leaders. The Health Plan Clinical Advisor...- Demonstrated experience in a client-facing role within the managed care environment - Demonstrated understanding of… more
- Prime Therapeutics (Columbus, OH)
- …as HIPAA, Anti-Kickback Statute, and False Claims Act, with a focus on PBM and managed care operations + Experience engaging with regulatory bodies (eg, CMS, ... company's brand and business + Provide strategic advice to senior leaders on the most complex legal scenarios +...of experience as an attorney and 5 years representing managed care companies, health care … more
- Evolent (Columbus, OH)
- …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... sales with long cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers and risk-bearing organizations)… more
- Molina Healthcare (Columbus, OH)
- …At least 8 years health care experience, including 6 years of managed care experience supporting clinical operations and clinical/quality improvement ... active and unrestricted in state of practice. * Deep understanding of clinical operations : utilization management, care management, etc. * Ability to provide… more
- Humana (Columbus, OH)
- …w/in 50 miles of a Humana office. + Healthcare industry experience, preferably in the managed care or provider sector + MBA, MA/MS, PhD, or graduate degree in ... organization) or has several years' experience with stakeholder management (strategy/ operations at a top-tier consulting/professional services firm). They will have… more
- UMB Bank (Columbus, OH)
- …assessment and underwriting of new SBCRE (Small Balance Commercial Real Estate) managed investment loans (non-owner occupied CRE loans $1,000,000 to $5,000,000) in ... suitable for each credit request. + Present loan submissions to the UMB senior loan committee on behalf of relationship managers and answer questions relative to… more
- Molina Healthcare (Columbus, OH)
- …strong leadership experience. + Minimum 5 years of healthcare, managed care , provider services and call center operations experience in government sponsored ... Description** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, performance, and adequacy,… more
