• Network Management Consultant - Remote

    Prime Therapeutics (Columbus, OH)
    …contracts, participation requirements, analysis of pharmacies, and ensuring contract and regulatory compliance . This position is accountable for creation and ... rules inclusive of approved preferred and specialty pharmacies; maintain key compliance criteria and implement quarterly reporting processes for all contracted… more
    Prime Therapeutics (08/14/25)
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  • EHS Manager

    Amcor (Fremont, OH)
    …EHS initiatives. *Conduct and/or coordinate EHS inspections and assessments to assure compliance with regulatory requirements, Amcor EHS initiatives and Amcor ... activities or other means. *Evaluate new materials and material use to ensure compliance with regulatory requirements, promote a safe work environment and… more
    Amcor (08/30/25)
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  • Medical Director -Pharmacy Appeals

    Humana (Columbus, OH)
    …accordance with Medicare and Humana policy. All work occurs within a context of regulatory compliance and work is assisted by diverse resources, included but not ... management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or clinical… more
    Humana (08/22/25)
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  • Care Management Coordinator - Field - OhioRISE NE…

    CVS Health (Columbus, OH)
    …of Care: o Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and ... Overview** As part of the bold vision to deliver the "Next Generation" of managed care in Ohio Medicaid, OhioRISE will help struggling children and their families by… more
    CVS Health (08/31/25)
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  • Credentialing and Privileging Specialist

    Highmark Health (Columbus, OH)
    …the results of all verifications and inquiries, as required by external regulatory standards and agreements between the Credentialing and Privileging Office AHN ... Staff according to the Medical Staff Bylaws and all federal/state regulatory and/or accrediting agencies. (15%) + Assists in organization and development… more
    Highmark Health (08/27/25)
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  • Quality Manager- Medical Device Manufacturing

    Ricoh Americas Corporation (Parma, OH)
    …quality responsibilities and documentation for the Ricoh 3D Printing for Healthcare covering production related quality activity for multiple sites. This position ... leadership and assures the quality of materials, products, systems, and processes in compliance with 21 CFR 820, ISO 13485, and other applicable regulations. The… more
    Ricoh Americas Corporation (07/29/25)
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  • President ProMedica Physicians

    ProMedica Health System (Toledo, OH)
    …working with the CMO to ensure that PPG and related physicians are in full compliance with all applicable regulatory agency rules and regulations to include but ... PPG continuous performance improvement on clinical, financial, service, access, and managed care standards. Works with PPG physician and executive leadership to… more
    ProMedica Health System (07/17/25)
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  • Enterprise Risk Management Analyst - Remote

    Prime Therapeutics (Columbus, OH)
    …skills and the ability to meet established deadlines **Preferred Qualifications** + Managed healthcare , health insurance, or other highly regulated industry + ... practices. This position will collaborates with various departments to ensure compliance with regulations and industry standards. **Responsibilities** + Support the… more
    Prime Therapeutics (08/31/25)
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  • RN Clinical Manager

    CenterWell (Mount Vernon, OH)
    …Plan of Care (POC). + Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensures final ... + Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical… more
    CenterWell (08/27/25)
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  • Facility Coding Inpatient Complex Coder

    Banner Health (OH)
    …areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office ... to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of… more
    Banner Health (07/10/25)
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