- Gentiva (Cincinnati, OH)
- …Minimum 3 years direct patient care experience + Knowledge of hospice principles, regulatory compliance , and managed care + Strong communication, ... program by managing patient care activities, supervising clinical staff, and ensuring compliance with all company policies and regulatory standards. **As a… more
- Highmark Health (Columbus, OH)
- …reimbursement programs. Strong knowledge of risk adjustment methodologies and reporting/ regulatory requirements and CMS Stars rating measures including HEDIS, CAHPS, ... and commercial populations with the goal of maximizing quality while reducing healthcare costs. + Support the identification of initiative impacts with other… more
- Prime Therapeutics (Columbus, OH)
- …clients, aligning technical capabilities with their growth strategies and regulatory environments; lead solution consulting, pre-sales, and thought leadership ... 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 without… more
- CVS Health (Columbus, OH)
- …member's goals + Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and ... skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration,… more
- CVS Health (Columbus, OH)
- …member's goals. + Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and ... skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/ collaboration,… more
- Humana (Columbus, OH)
- …+ **Enterprise environment** experience with large-scale red team operations. + ** Regulatory compliance ** knowledge relevant to adversary simulation (SOX, PCI, ... HIPAA). + **Consulting or managed services** background with client-facing technical communication. + **Cross-functional collaboration** with IT, compliance , and… more
- OhioHealth (Columbus, OH)
- …entry functions as needed, including LMRP evaluation, pre-registration functions and managed care procedures. e. Accurately processes orders using computerized or ... for new employees of the respective areas and monitors the employee's compliance with standard operating procedures. f. Cooperates with the training program… more
- Humana (Columbus, OH)
- …financial results, and many ad hoc analyses related to the business (risk, compliance , operations, etc.) They will advise market leadership and executives to develop ... peer-reviewed results **Preferred Qualifications** + 5 years of experience within the managed Medicaid industry + 3 years of project management experience + In… more
- ChenMed (Columbus, OH)
- …arrivals. This position adheres to strict departmental goals/objectives, standards of performance, regulatory compliance , quality patient care compliance and ... Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires...days of employment We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare … more
- Grifols Shared Services North America, Inc (Cincinnati, OH)
- …work performance and deliverables meet or exceed goals and objectives. + Ensures compliance with all applicable regulatory , legal, and operational rules and ... an international team working to improve the future of healthcare ? Do you want to enhance the lives of...to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and… more