- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (Columbus, OH)
- …Duals Center of Excellence, clinical, compliance, analytics and network teams, the Senior Manager drives innovation and operational excellence to optimize member ... lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This… more
- Humana (Columbus, OH)
- …are 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...+ This role is part of Humana's Driver safety program and therefore requires an individual to have a… more
- Elevance Health (Columbus, OH)
- …Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Position Summary** As a Senior Legal Counsel, Pharmacy Benefit Manager (PBM) you will provide legal guidance, ... advice and recommendations for action to internal stakeholders and senior /executive management regarding federal/state regulations in the healthcare industry. Serves… more
- CVS Health (Columbus, OH)
- …and every day. **Position Summary** We are seeking a highly skilled and experienced Senior Data Engineering Manager to lead and mentor our data engineering team ... team that is responsible for processing Claims, Revenue, and Medicare Specific files and data from 30+ payors into...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- CVS Health (Columbus, OH)
- …for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC arrangements ... with others to meet/exceed expectations **Preferred Qualifications** + Experience in Medicare Advantage and/or Value Based Contracting + Ability to remain flexible… more
- Humana (Columbus, OH)
- …Experience Platform (AEP) and Next Best Action (NBA) execution to join the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Our… more
- CVS Health (Columbus, OH)
- …Ensures compliance with contractual requirements. Coordinates and collaborates with program integrity staff, compliance, and senior leadership. Contributes ... A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / ...Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and… more
- CVS Health (Columbus, OH)
- …current business trends and best practices by preparing analyses for senior management, stakeholders, and clients.** **Preferred Qualifications** **3+ year vendor ... benefit administrators)** **5+ years of experience in government programs (Medicaid, Medicare )** **Adept at problem solving and decision-making skills** **Adept at… more
- CenterWell (Columbus, OH)
- …responsible for the medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care's (and Conviva Senior Primary Care's) Home-Based ... Care portfolio, serving the highest-need and most complex senior patients. This role will lead clinical strategy, quality improvement, and care delivery innovation… more
- Molina Healthcare (Columbus, OH)
- …skills. * Microsoft Office suite (including Excel), and applicable software program (s) proficiency. **Preferred Qualifications** * Medicare Part D and/or ... care team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...pharmacy call center team under the direction of pharmacy senior leadership. * Identifies and implements programs to improve… more