- Fifth Third Bank, NA (Cincinnati, OH)
- …strict servicing guidelines throughout the defaultcycle. Responsible and accountable for risk by openly exchanging ideas and opinions, elevating concerns, and ... drive a positive customer experience. While operating within the Bank's risk appetite, achieves results by consistently identifying, assessing, managing, monitoring,… more
- ZOLL Medical Corporation (Columbus, OH)
- …to protect more than 1M patients at risk of sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia-management-system/) ... prevent delays in the appropriate provision of services and products and reduce risk to recurring revenue streams. + Develop and maintain full working knowledge of… more
- The Hartford (Columbus, OH)
- …business process efficiency through triaging, automation and AI tooling, drive risk selection and prospecting prioritization, and embed advanced analytics of all ... customer segments, and competitive pricing strategies. + Consults on innovative risk strategies using proprietary systems/data sources to achieve extensive business… more
- Stantec (Cleveland, OH)
- …critical paths, perform total float analysis, correlate schedule, cost, and risk assessments, and periodically report the project management status of critical ... reports with bar charts, S-curves, and manpower histograms. - Perform schedule risk analysis periodically or as required. - Provide support on the development… more
- Molina Healthcare (OH)
- …Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to maximize ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. Ongoing… more
- The Cigna Group (Cleveland, OH)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... develops networks and identifies opportunities for greater value-orientation and risk arrangements. + Contributes to the development of alternative network… more
- Molina Healthcare (OH)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL ... including expected and actual revenues/volumes, past performance, proposed contract language, risk adjustment and regulatory changes To all current Molina employees:… more
- CVS Health (Columbus, OH)
- …accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. + Protects the confidentiality ... regarding confidentiality. + May assist in the research and resolution of claims payment issues. Supports the administration of the hospital care, case management… more
- Molina Healthcare (Columbus, OH)
- …& ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed ... including but not limited to, fee-for service, capitation and various forms of risk , ASO, etc. **PREFERRED EDUCATION** : Bachelor's Degree in a related field or… more
- Capgemini (Cincinnati, OH)
- …Medicaid or Exchange program/ product build knowledge (Enrollment, Eligibility, Claims , Provider network, encounters etc) (Highly Recommended having exposure to ... an expedited fashion Partner with project team to monitor and manage schedule, risk , issues, actions, decisions and change requests Partner with project team to plan… more