- Humana (Columbus, OH)
- …and help us put health first** We are seeking a dynamic and results-driven Sales Manager to lead our Agnostic Call Center Sales Team within the IFG line of business. ... in a fast-paced, remote sales environment. The Agnostic Sales Manager leads and grows an internal sales team for...Paid Holidays + 401(k) retirement savings plan + Tuition reimbursement and/or scholarships for qualifying dependent children + And… more
- Trinity Health (Westerville, OH)
- …Full time **Shift:** Day Shift **Description:** RN Case Manager , Full-time **Why Mount Carmel?** With five hospitals ... (https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive outreach and… more
- Centene Corporation (Fairlawn, OH)
- …including a fresh perspective on workplace flexibility. **Centene is hiring a Care Manager (RN) for our Buckeye Health Plan, supporting the MyCare Ohio MMP ( ... Medicare -Medicaid Plan) Duals Program.** **This is a hybrid position...pay, health insurance, 401K and stock purchase plans, tuition reimbursement , paid time off plus holidays, and a flexible… more
- CVS Health (Columbus, OH)
- …Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, conduct high-level reviews and ... and the review and analysis of reports as part of negotiation and reimbursement modeling activities. * Responsible for identifying and managing cost issues and… more
- OhioHealth (Columbus, OH)
- …and billing. Must have the ability to research complex issues pertaining to Medicare reimbursement and payment policies. This position assists in development, ... implementation, refinement and reporting of the RAC case management and appeals program. It is accountable for reviewing documentation of clinical care provided, financial outcomes of an assigned population, coordinating clinical documentation, drafting appeal… 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
- Medical Mutual of Ohio (Brooklyn, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Provides expertise to ... Specialist or equivalent experience. **Professional Certification(s)** + Certified Purchasing Manager (preferred) **Technical Skills and Knowledge:** + Experience with… more
- Molina Healthcare (Cincinnati, OH)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …and understanding of the current trends and developments in healthcare reimbursement and development of specific payer strategies, including investigation of new ... opportunities, regulations, standards and directives regarding governmental/third party agencies ( Medicare & Medicaid) and/or third paLeads assigned negotiations of… more
- Option Care Health (Hudson, OH)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of...health agencies in the absence of a director or Manager of Nursing. + Manages daily activities with regards… more