- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Director , Financial Planning & Analysis analyzes and forecasts financial, economic, and other data ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Humana (Columbus, OH)
- …support across a broad range of actuarial, managerial, and business needs for Medicaid -specific product lines. The Lead Actuary will serve as a project manager in ... and documentation. The Lead Actuary will be responsible for Medicaid -specific functions such as capitation rate review, drafting rate...on the business. They will work closely with the Director to ensure key workstreams are meeting timelines and… more
- Evolent (Columbus, OH)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology to ... innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple opportunities for a… more
- Molina Healthcare (Akron, OH)
- …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Program Director is a key Quality Improvement (QI) leader within the ... needs. + Manages QI programs with oversight from the Director , AVP and VP as needed. + Collaborates and...of and experience with HEDIS programs. + 2 years Medicaid experience + 2 years Medicare experience + 3… more
- Molina Healthcare (Akron, OH)
- …standards and requirements established by the Centers for Medicare and Medicaid . **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of the ... within a managed care setting. **Preferred Education** Bachelor's degree Previous Director experience. To all current Molina employees: If you are interested… more
- Molina Healthcare (Columbus, OH)
- …with business and other IT teams to deliver successful and certifiable Medicaid Management Information Systems solutions. * Works closely with EPMO, business ... stakeholders to manage priorities deliveries and expectations. **Job Qualifications** **Required Education** Graduate Degree or equivalent combination of education and experience **Required Experience** 7-9 years Application Design, Development Experience and,… more
- Humana (Columbus, OH)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... must be able to start with 30-60 days of hire. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more