- Molina Healthcare (Covington, KY)
- …SummaryProvides subject matter expertise and leadership to healthcare services function - providing support for project/ program /process design, execution, ... into functional requirements. * Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality… more
- Molina Healthcare (Covington, KY)
- …work of external vendors. Assigns, directs, and monitors system analysis and program staff. These positions' primary focus is project/ program management, rather ... teams in planning and executing business programs. Assigns and monitors work of program management staff providing support and direction. + Serves as the subject… more
- Molina Healthcare (Covington, KY)
- …(No Weekends or Holidays) Job Summary Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: ... and application of protocols and guidelines. * Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources,… more
- Molina Healthcare (Covington, KY)
- …and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits and overpayment ... and executing projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment… more
- Molina Healthcare (Covington, KY)
- …governance framework and decision-making processes, as needed. + At the direction of program (CoE, Shared Service or other functional area) leadership, supports ... or a similar field). + Relevant work experience in healthcare compliance program operations and risk management;...experience. + Managed Care experience, preferably in a shared service , CoE or matrixed environment. + Experience with Microsoft… more
- Molina Healthcare (Covington, KY)
- …lives in Kentucky and must be licensed for the state of Kentucky Case Manager RN will work with KY Behavioral Health Medicaid population providing telephonic case ... for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services...resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and… more
- Molina Healthcare (Covington, KY)
- …verbal and written communication skills. * Microsoft Office suite/applicable software program (s) proficiency. Preferred Qualifications * Certified Case Manager ... in Kentucky and must be licensed for the state of Kentucky. Case Manager will work with KY Medicaid/Medicare population providing telephonic case management support.… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead a small team of investigators and provide ... daily investigative activities as a back-up to the SIU Manager . This position will be accountable for tracking on...policies and be able to apply them in ensuring program compliance via payment integrity programs. The position must… more
- Saint-Gobain (Silver Grove, KY)
- …a manner to achieve maximum productivity and operating efficiencies within safety, quality, service , and cost standards. The Performance Area Manager will be ... **Performance Area Manager - Mill, Active Storage and Finishing:** Consistent...options to fit your unique lives! Our Total Rewards Program is customizable to accommodate your needs. Our menu… more
- Molina Healthcare (Covington, KY)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified ... procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. +… more
- Molina Healthcare (Covington, KY)
- …oversight and expertise related to behavioral health and chemical dependency services , and assists with implementation of integrated behavioral health care programs ... management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize… more
- Molina Healthcare (Covington, KY)
- …medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for ... Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports plan utilization management program… more
- Molina Healthcare (Covington, KY)
- …entry and telephone and clerical support for team facilitating care management related services for members. * Facilitates initial review of assigned case levels and ... needs and works under the direction of the care manager to implement care plan. * Schedules member visits...care management staff during process of identifying appropriate member services . * Coordinates required member services in… more
- Molina Healthcare (Covington, KY)
- …Duties** * Hires, trains, develops, and supervises a team of pharmacy service representatives supporting processes involved with Medicare Stars and Pharmacy quality ... and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. * Ensures that adequate staffing coverage is present at all… more
- Raising Cane's (Georgetown, KY)
- …action when needed + Directs crewmembers during a shift + Provides exemplary customer service + Utilizes reward and recognition program for the crewmembers in ... Managers: + Medical, Dental, Vision & Pharmacy Benefits + Dependent Care & Healthcare Flexible Spending Account + Pet Insurance + 401(k) With Employer Match (age… more
- Amazon (Erlanger, KY)
- …packages including comprehensive healthcare benefits starting on Day 1, matching 401(k) program , and up to 20 weeks of paid parental leave. But wait, there's ... We are known for our speed, accuracy, and exceptional service . Our buildings deliver tens of thousands of products...our journey! About the Role: As the Automation Engineer Manager , you will lead a team in driving equipment… more
- Walgreens (Florence, KY)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... cash register, provides customers with courteous, fair, friendly, and efficient checkout service . + In accordance with state and federal regulations, assists the… more
- Walgreens (Florence, KY)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... services as required; assists pharmacy staff in coordination of clinical services , Walgreens healthcare clinics and external providers. + Assists Pharmacy … more
- Walgreens (Madeira, OH)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... services as required; assists pharmacy staff in coordination of clinical services , Walgreens healthcare clinics and external providers. + Assists Pharmacy … more
- CVS Health (Florence, KY)
- …genuine, authentic care for our patients. In addition to supporting the Pharmacy Manager in leading and directing the pharmacy team, you are accountable for ... dispensing, counseling, and immunizing practices + Taking direction from the Pharmacy Manager and overseeing the pharmacy as their proxy during bench shifts without… more