- Elevance Health (Mason, OH)
- …or post-doctoral training in conducting health services research with experience in biostatistics, managed care , health care systems, health policy, or ... in health services, health economics, and health policy evaluation of innovative care delivery models. + Support research activities in the following areas: research… more
- Molina Healthcare (Cincinnati, OH)
- …preferred. **Required Experience** + 3-5 years clinical nursing experience, with 1-3 years Managed Care Experience in the specific programs supported by the plan ... of service provided, length of stay and level of care . + Applies appropriate criteria on PAR and Non-PAR...Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional… more
- UMB Bank (Columbus, OH)
- …assessment and underwriting of new SBCRE (Small Balance Commercial Real Estate) managed investment loans (non-owner occupied CRE loans $1,000,000 to $5,000,000) in ... all of or portions of the credit packages (as agreed with the relationship manager ) for submission to credit committee for approval (new business and renewals) +… more
- AbbVie (Mentor, OH)
- …Commercial pharmaceutical industry experiences such as physician/account-based selling, training, managed health care or marketing preferred. English language ... lives across several key therapeutic areas - immunology, oncology, neuroscience, and eye care - and products and services in our Allergan Aesthetics portfolio. For… more
- Elevance Health (Cincinnati, OH)
- …through strong communication and interpersonal skills. + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as ... such as contract negotiations, provider network optimization, and total cost of care management. + Thoroughly vet and perform due diligence on potential value-based… more
- Prime Therapeutics (Columbus, OH)
- …function or similar area for a Pharmacy Benefit Manager (PBM), health plan, or managed care organization + Must be eligible to work in the United States ... for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded...and work collaboratively to provide the highest quality of care and service to our members. If you are… more
- Molina Healthcare (Columbus, OH)
- …**N** **C** **E:** + 3+ years of medical record abstraction experience + 3+ years managed care experience. + Advanced knowledge of HEDIS and NCQA. **PR** **E** ... meetings with vendors for the medical record collection process. + Assists Manager and Supervisor(s) in training, utilizing the standardized training materials and… more
- Molina Healthcare (Dayton, OH)
- …adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either ... able to confirm outcomes meet the specific state/federal requirements. + Assists manager in establishing standards, guidelines, and best practices for the audit team… more
- PNC (Miamisburg, OH)
- …field on a regular basis. Some responsibilities may be performed remotely, at the manager 's discretion. Preferred skills and experience: * .Net * SQL server * DevOps ... * Azure * self- managed * API knowledge and support, * experience in...with PNC match, pension and stock purchase plans; dependent care reimbursement account; back-up child/elder care ; adoption,… more
- Elevance Health (Cincinnati, OH)
- …equivalent background. **Preferred Skills, Capabilities, and Experiences:** + Understanding of managed care or Medicaid/Medicare strongly preferred. + Cover ... autism and depression, and insightful analytics to improve the delivery of care . The **Medical Management Specialist I** is responsible for providing non-clinical… more