- Humana (Columbus, OH)
- …of financial operations for Humana's Michigan HIDE Plan with a focus on Medicaid and state partnership, oversees the budget, financial reporting, and all audit ... **Key Responsibilities** + Provides market specific financial leadership in the State Medicaid Market, developing a deep understanding of Humana's Medicaid … more
- CenterWell (Columbus, OH)
- …a part of our caring community and help us put health first** The Medicaid Drug Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, ... drug strategies to mitigate cost trend and improve health outcomes. The Medicaid Drug Strategy Pharmacist Lead work assignments involve moderately complex to complex… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Molina Healthcare (OH)
- …Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and ... impact of provider reimbursement changes + Provide data driven analytics to Finance , Claims, Medical Management, Network, and other departments to enable critical… more
- Butler County Regional Transit Authority (Cincinnati, OH)
- The Butler County Regional Transit Authority (BCRTA) is seeking a mid-career finance professional with experience in public entity finance and accounting. The ... SUMMARY Under the general direction of the Director of Finance & Administration, the Finance and Accounting...analysis and reconciliation. + Ensures agency compliance with the Medicaid Provider Agreement and all relevant ORC, OAC, and… more
- Humana (Columbus, OH)
- …and other business functions to implement formulary and medical strategies for the Medicaid line of business. Makes decisions on moderately complex to complex issues ... other business functions to implement formulary and medical strategies for the Medicaid line of business. + Utilizes broad understanding of pharmacy, managed care,… more
- Molina Healthcare (Cincinnati, OH)
- …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... oversight. + Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.… more
- Molina Healthcare (Akron, OH)
- …oversight. + Collaborate with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies. ... requirements, workflows, and solutions that drive measurable improvement. + Partner with finance and compliance to develop business cases and support reporting that… more
- Humana (Columbus, OH)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid /Medicare. Looking for long-term improvements of encounter submission processes. Begins to… more
- Prime Therapeutics (Columbus, OH)
- …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... compliance with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid … more