- Molina Healthcare (Akron, 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 (Akron, 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 (Akron, 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
- Molina Healthcare (Akron, 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
- Molina Healthcare (Akron, 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 (Akron, OH)
- …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
- Molina Healthcare (Akron, 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
- Molina Healthcare (Akron, 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
- The Cigna Group (Akron, 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