- Molina Healthcare (Cincinnati, 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
- Molina Healthcare (Covington, KY)
- …+ 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
- ADM (Erlanger, KY)
- **102062BR** **Job Title:** Senior Manager ITSM - Applications - Erlanger, KY **Department/Function:** Information Technology **Job Description:** ** Senior ... for a results oriented Service Owner role within Global Technology's Operations Excellence and Provider Performance function **Purpose and Scope:** The Service… more
- Molina Healthcare (Covington, KY)
- …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
- Molina Healthcare (Covington, KY)
- …**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 (Covington, KY)
- …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
- Molina Healthcare (Covington, KY)
- …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including 2+ years ... activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider… more
- CenterWell (Fort Mitchell, KY)
- …by clinical personnel. + Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed . + Conducts/delegates the ... the Human Resources Department and the Executive Director/Director of Operations . + Participates in the interviewing, hiring, training, and...at the center. As the nation's largest provider of senior -focused primary care , one of the largest… more
- Molina Healthcare (Covington, KY)
- …years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care environment, or ... care management, long-term services and supports (LTSS), clinical operations and business processes. Considers business problems "end-to-end": including people,… more
- Robert Half (Cincinnati, OH)
- …independent and locally owned Member Firms provide clients with consulting and managed solutions in finance, technology, operations , data, analytics, digital, ... is a passion. We lean into our mission: We Care . We Collaborate. We Deliver . At every level,...team, you will oversee a team of analysts and senior analysts through multiple projects to ensure quality and… more