• Risk Adjustment Audit Operations Analyst…

    Molina Healthcare (Cincinnati, OH)
    …Familiarity with Medicare Advantage or Medicaid programs + Awareness of CMS audit processes or healthcare compliance requirements **Ideal Candidate Attributes** ... Data Validation) team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of chart retrieval chase… more
    Molina Healthcare (08/08/25)
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  • Healthcare Process Risk Manager (Internal…

    Grant Thornton (Cleveland, OH)
    …and the overall effectiveness and efficiency of processes. + Oversee internal audit outsourcing and co-sourcing engagements for clients. + Manage the risk ... 4 years of direct experience with diverse life sciences companies or healthcare providers, including hospitals, academic medical centers, healthcare systems, and… more
    Grant Thornton (08/08/25)
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  • Senior Risk Partner - Compliance Officer

    Highmark Health (Columbus, OH)
    …related field **EXPERIENCE** **Required** + 7 years in compliance, privacy, government affairs, healthcare operations, risk, audit , or legal functions + 5 years ... role ​ **Preferred** + 10 years in compliance, privacy, government affairs, healthcare operations, risk, audit , or legal functions + 5 years in Healthcare … more
    Highmark Health (07/29/25)
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  • Audit Business Manager, Meritain TPA Remote

    CVS Health (New Albany, OH)
    …remote or hybrid depending on candidate location.** **Minimum Requirements** + Minimum 4 years audit experience or in related field + Healthcare or TPA industry ... etc.** Engages all appropriate parties and **implements best practices and develops Audit Policies & Procedures.** + Assesses and validates the effectiveness of… more
    CVS Health (08/21/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Mason, OH)
    ** Audit & Reimbursement Senior** **_Virtual:_** _This role enables associates to work virtually full-time, with the exception of required in-person training ... Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC)… more
    Elevance Health (08/08/25)
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  • Audit & Reimbursement III (US)

    Elevance Health (Mason, OH)
    ** Audit & Reimbursement III** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and Medicaid Services to transform federal health programs. The ** Audit & Reimbursement III** is responsible for completing limited...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
    Elevance Health (08/14/25)
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  • Recovery Audit Analyst I

    Elevance Health (Mason, OH)
    **Recovery Audit Analyst I** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... accommodation is granted as required by law. The **Recovery Audit Analyst I** is responsible for auditing and facilitating...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
    Elevance Health (08/19/25)
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  • Inpatient Audit Specialist

    Datavant (Columbus, OH)
    …company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right ... team. Together, we're rising to the challenge of tackling some of healthcare 's most complex problems with technology-forward solutions. Datavanters bring a diversity… more
    Datavant (08/13/25)
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  • Inpatient Audit Specialist

    Datavant (Columbus, OH)
    …company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right ... team. Together, we're rising to the challenge of tackling some of healthcare 's most complex problems with technology-forward solutions. Datavanters bring a diversity… more
    Datavant (07/29/25)
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  • Specialist, Configuration Oversight…

    Molina Healthcare (Columbus, OH)
    …Responsible for conducting various audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure ... schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit… more
    Molina Healthcare (08/16/25)
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