- 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
- 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
- Deloitte (Columbus, OH)
- …consulting services to public sector clients + Support engagements focused on Medicaid reimbursement , including actuarial rate development across managed care ... and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk...Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie, DSH, UPL, etc.) + Experience with… more
- Humana (Columbus, OH)
- … Business Intelligence Engineer will develop and maintain expertise in complex Medicare reimbursement methodologies. This role is within the Integrated Pricing ... on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement /editing logic and Humana system logic **Use your skills… more
- Humana (Columbus, OH)
- …looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- 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. ... us put health first** Humana Healthy Horizons is seeking a Senior Value-Based Programs professional who will support successful value-based provider relationships… more
- Cardinal Health (Columbus, OH)
- …insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare , Medicaid , Managed Care, and ... get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and… more
- Molina Healthcare (Columbus, OH)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and… more
- Molina Healthcare (Columbus, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development… more
- Centene Corporation (Columbus, OH)
- … Medicaid . + Lead population health initiatives with a strong focus on Medicaid while collaborating with partners on Medicare and Marketplace programs. + ... President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies...the direction of Centene and the Ohio Department of Medicaid . While the primary focus is on Medicaid… more
- 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. ... executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and… more
- Baylor Scott & White Health (Columbus, OH)
- …and senior medical staff including denials from all payers, Medicare / Medicaid audit activities and key contract enforcement activities. + Collaborates ... to improve appeal success rates, ensure regulatory compliance and optimize reimbursement outcomes. Will lead external resources through vendor or contractor… more
- Molina Healthcare (Columbus, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... regulatory and/or functional requirements related but not limited to coverage, reimbursement , and processing functions to support systems solutions development and… more
- Cardinal Health (Columbus, OH)
- …of insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid , commercial insurance plans, and managed care preferred. + ... Review aging reports and work insurance accounts to ensure timely resolution and reimbursement . + Contact insurance companies via phone, portals, or email to check… more
- Molina Healthcare (Columbus, OH)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development… more
- Molina Healthcare (Columbus, OH)
- …observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. ... manages a team of medical economics team of professionals. * Collaborates with senior level clinicians and leaders from functional areas such as finance, health care… more
- Cardinal Health (Columbus, OH)
- …preferred. + Strong understanding of medical billing practices, payer guidelines, and reimbursement methodologies (commercial, Medicare , Medicaid ). + Proven ... recommend and implement preventive measures. + Prepare and present reports to senior leadership on collection performance, trends, and areas for improvement. +… more