- Humana (Columbus, OH)
- …care management, provider relations, quality of care, audit, grievance and appeal and policy review. The Behavioral Health Medical Director will develop and ... **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care… more
- Elevance Health (Independence, OH)
- … health initiatives, ensuring alignment with the Ohio Department of Medicaid priorities and state-designated population health goals. The Program Manager ... outcomes strongly preferred. + Familiarity with the Ohio Department of Medicaid 's Population Health Stair-Step approach strongly preferred. + Experience… more
- Elevance Health (Mason, OH)
- …of an Extraordinary Team** CarelonRx is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By ... Make an Extraordinary Impact.** **Title** : Clinical Pharmacist, Population Health **Location(s):** Mason, OH, Cincinnati, OH, Seven Hills, OH, Columbus,… more
- Elevance Health (Mason, OH)
- …will live in VA, OH, IN or FL._ _Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting ... for ensuring regulatory compliance, operational readiness, and strategic alignment across Medicare- Medicaid integrated products. **How you will make an impact:** +… more
- Highmark Health (Columbus, OH)
- …CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values ( Health Outcomes Measures). Provide actionable opportunities in provider transformation aimed at ... Medicaid HEDIS, risk revenue value streams, and population health management. **Preferred** + 7 years of experience in...all areas of the corporation, by understanding corporate strategies, policy , and scope of authority + Because of the… more
- Humana (Columbus, OH)
- …Nursing experience + Previous experience in utilization management with ASAM knowledge + Health Plan experience + Previous Medicare/ Medicaid Experience a plus + ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure ... successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards via… more
- Elevance Health (Columbus, OH)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and ... for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement II will… more
- CVS Health (Columbus, OH)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...deliver the "Next Generation" of managed care in Ohio Medicaid , OhioRISE will help struggling children and their families… more
- Elevance Health (Columbus, OH)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and ... onboarding and skill development._ Please note that per our policy on hybrid/virtual work, candidates not within a reasonable...Medicaid Services (CMS) division of the Department of Health and Human Services). The Audit and Reimbursement Senior… more