- Molina Healthcare (Columbus, 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
- CVS Health (Columbus, OH)
- …and more compassionate. And we do it all with heart, each and every day. As a Senior Manager within the Aetna Medicare Pharmacy team, you will play a ... critical role in shaping and executing the organization's Medicare Part D formulary and product strategy. Leveraging your...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Position Summary** As a Senior Legal Counsel, Pharmacy Benefit Manager (PBM) you will provide legal guidance, ... advice and recommendations for action to internal stakeholders and senior /executive management regarding federal/state regulations in the healthcare industry. Serves… more
- 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 ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- CVS Health (Columbus, OH)
- …and every day. **Position Summary** We are seeking a highly skilled and experienced Senior Data Engineering Manager to lead and mentor our data engineering team ... team that is responsible for processing Claims, Revenue, and Medicare Specific files and data from 30+ payors into...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Columbus, OH)
- …Qualifications** + Pharmacist + 7-10 years work experience in healthcare + Medicare and/or Medicare -Medicaid Integrated Product Experience + Experience with Part ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...includes an award target in the company's equity award program . Our people fuel our future. Our teams reflect… more
- Humana (Columbus, OH)
- …Experience Platform (AEP) and Next Best Action (NBA) execution to join the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Our… more
- OhioHealth (Marion, OH)
- …implementing, communicating, managing and monitoring the needs of the physician contracting program . This role is a subject matter expert, with current knowledge of ... is to: (a) lead and manage the physician contracting program by ensuring all individual physician and physician group...of the Inspector General, The Joint Commission, Center for Medicare & Medicaid Services, Internal Revenue Service, etc. This… more
- CVS Health (Columbus, OH)
- …Ensures compliance with contractual requirements. Coordinates and collaborates with program integrity staff, compliance, and senior leadership. Contributes ... A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / ...Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and… more
- Molina Healthcare (Columbus, OH)
- …identified, mitigated, monitored, and reported. Responsible for managing the program governance, strategy, tool(s), policy, standards, and procedures. Responsible ... and vendors are effectively and robustly managed. + Ensures the appropriate governance program and relevant training programs are in place and maintained. + Drive… more
- CVS Health (Columbus, OH)
- …current business trends and best practices by preparing analyses for senior management, stakeholders, and clients.** **Preferred Qualifications** **3+ year vendor ... benefit administrators)** **5+ years of experience in government programs (Medicaid, Medicare )** **Adept at problem solving and decision-making skills** **Adept at… more
- CenterWell (Columbus, OH)
- …part of our caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program … more
- CVS Health (Columbus, OH)
- …is an integral part of the Medicare Stars business. We are seeking a ** Senior Manager , Business Analysis** , to join our team. This team manages data ... environments, reporting and web applications that support Medicare and Stars-specific initiatives. **This position will include:** +...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Columbus, OH)
- …the delivery of high quality care to the Medicare population. As a Senior Product Manager , you will be responsible for driving the strategic direction of ... a core part of our platform. Through partnership with senior business and engineering leaders, you will oversee the...experience **Preferred Qualifications** 4+ years operating in a Product Manager role (or similar) MA / MBA in any… more
- CenterWell (Columbus, OH)
- …Health, Federal, and local agencies. + Oversee and manage Medicaid and Medicare enrollment, renewal, and compliance activities. + Track expiration dates and ... eligible dependents + Caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more