- Battelle Memorial Institute (Columbus, OH)
- …technical leader interfaces are the program managers, contracts, finance, quality, operations , suppliers, and our customers. This engineering leadership position is ... has a thorough knowledge of contractual issues relative to the program being managed relevant to scope of the work, scheduling and subcontracts. Advises contract… more
- Molina Healthcare (Columbus, 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
- UKG (Columbus, OH)
- …you'll thrive in our fast-paced, mission-driven environment. **About the Role** As a ** Senior Sales Consultant - Managed Services** , you will serve as ... code you ship, the decisions you make, and the care you show a customer all add up to...ee+)** , helping them reimagine their HR and payroll operations through UKG's fully managed offerings. You… more
- Molina Healthcare (Columbus, 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
- Evolent (Columbus, OH)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Experience with ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Humana (Columbus, OH)
- …and presentation skills **Preferred Qualifications:** + Experience with Medicaid managed care **Additional Information** **WAH Internet Statement** To ... and help us put health first** The Value Based Market Support Senior Professional is responsible for providing comprehensive market support across assigned markets… more
- Humana (Columbus, OH)
- …as Computer Science, Mathematics or Statistics and/or related field + Healthcare or managed care experience + Experience performing data management, mining, and ... we deliver world class solutions that address inefficiencies in the health care . The Senior Cognitive/Machine Learning Professional collaborates with analytic… more
- Molina Healthcare (Columbus, 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
- Western Digital (Columbus, OH)
- …needs * Facilitate technical requirements and maintain well-defined roadmaps with senior stakeholders **Legal Technology Leadership** * Serve as in-house expert on ... Change Management** * Continuously identify automation and innovation opportunities in legal operations * Track system usage, impact, and satisfaction metrics * Lead… more
- Molina Healthcare (Columbus, 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 (Columbus, 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
- Humana (Columbus, OH)
- …+ Lead and provide direction for our Managed Service Provider (MSP) + Lead Managed Service Provider in Operations for Azure, GCP and AWS Cloud environment + ... point) for Incident Management + Participate and develop client relationships within Operations , Business partners, Managed Service Providers and Cloud Providers… more
- Centene Corporation (Columbus, OH)
- …**Education/Experience:** Current state RN license preferred. Previous experience in a managed care organization strongly preferred. 3+ years of leadership ... The Vice President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies that drive measurable… more
- CVS Health (Columbus, OH)
- …of the time as required to meet business needs. **Required Qualifications** 3+ years of managed care Pharmacist experience and/or 1 year of Managed Care ... team, pharmacists, medical directors, CMO as well as other senior health plan leaders. The Health Plan Clinical Advisor...- Demonstrated experience in a client-facing role within the managed care environment - Demonstrated understanding of… more
- OhioHealth (Columbus, OH)
- …of all backgrounds and educational levels. In-depth knowledge of healthcare management, acute care operations , managed care , and population/community ... stakeholders to drive quality, performance and innovation, ensuring effective operations and accountability for OhioHealth's growth strategies. The role...will also work in conjunction with the VP of Managed Care to set strategic direction for… more
- Trinity Health (New Albany, OH)
- …Participates with the Senior Leadership Team of the RHM in all Managed Care strategies and negotiations. Participates in Senior Leadership Council ... strategic operations of the RHM. Works directly with the Senior Vice President of Clinical Care at Trinity Health in bridging the clinical arena of the RHM… more
- Prime Therapeutics (Columbus, OH)
- …as HIPAA, Anti-Kickback Statute, and False Claims Act, with a focus on PBM and managed care operations + Experience engaging with regulatory bodies (eg, CMS, ... company's brand and business + Provide strategic advice to senior leaders on the most complex legal scenarios +...of experience as an attorney and 5 years representing managed care companies, health care … more
- Evolent (Columbus, OH)
- …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... sales with long cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers and risk-bearing organizations)… more
- OhioHealth (Columbus, OH)
- …system operations , finance, policy governance, community benefit, customer service, and managed care . 15% Assists Direct Supervisor or other members of the ... everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover...They Function: -Attends at least one Medical Executive, one Senior Management, and one Operations Management meeting.… more
- Centene Corporation (Columbus, OH)
- …applications and project management tools required. Healthcare experience and/or managed care experience preferred. **License/Certification:** Project Management ... or more project managers/business analysts who are managing the individual workgroups ( Operations , Finance, Benefit Operations , etc.) involved in the project. +… more
