- Molina Healthcare (Akron, OH)
- …Google or Adobe analytics (or similar) Google AdWords, Tag Manager systems, (Adobe or Google) CMS ( content management system ) Google Ads SEO, SEM, CRM ... and incorporate learnings to drive continuous improvements + Create promotional and content strategies to expand digital reach + Collaborate on developing content… more
- Humana (Columbus, OH)
- …and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual ... Medicare /Medicaid and Waiver requests. The Medical Director provides medical...other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some… more
- CVS Health (Columbus, OH)
- …researching and resolving Medicare complaints received via the Centers for Medicaid and Medicare Services ( CMS ). In this role, you will manage a queue of ... Medicare knowledge/experience + Prior experience with complaints and/or Center for Medicare and Medicaid Services ( CMS ) + Medical/RX claim processing… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Supports corporate and ... lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid), including HEDIS audit submission, Consumer Assessment… more
- Ensono (Columbus, OH)
- …Interchange (EFI), Next Generation Desktop (NGD), Electronic File Interchange (EFI), and the CMS Identity Management System (IDM). **Why Ensono?** Ensono is ... and FIPS 140-2, as applicable. + Maintain and renew certifications required for system access and management , ensuring continued compliance and eligibility. +… more
- ABBTECH Professional Resources, Inc. (Columbus, OH)
- …impact as a Tableau/Data Visualization and Reports Analyst supporting the Centers for Medicare & Medicaid Services ( CMS ). It's your place to make meaningful** ... load with Apex Data Loader.** Healthcare Service Industry and/or Center for Medicare and Medicaid Services ( CMS ) experience.** Experience mentoring junior level… more
- CenterWell (Columbus, OH)
- …DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare ... in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- CenterWell (Columbus, OH)
- …procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare ... in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- Molina Healthcare (Cleveland, OH)
- …to achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services ( CMS ) and State regulatory requirements are met ... **Job Qualifications** **REQUIRED QUALIFICATIONS:** + Experience demonstrating knowledge of CMS Guidelines, MCG, InterQual or other medically appropriate clinical… more
- CVS Health (Cleveland, OH)
- …of quality, sales effectiveness, retention, secret shopper initiatives, and state, federal, and CMS requirements for Medicare sales agents and programs + 0-3 ... and retain through the use of the Aetna IVL Medicare product portfolio.This role will deploy an operating model...integrated tech stack the call interactions, COIs, and lead management protocols with new and existing members. + Develop,… more