- Bon Secours Mercy Health (Cincinnati, OH)
- …Bon Secours Mercy Health, we are dedicated to continually improving health care quality , safety and cost effectiveness. Our hospitals, care sites and clinicians are ... academic programs, manages board and external relations, addresses issue of risk and crisis management, manages policy and institutional document alignment/updates.… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …other engineers design systems, scope and decompose projects, manage technical debt and risk , promote best practices, and mentor others on the team. You will also ... collaborative problem solving, sophisticated design, and the creation of quality products are essential. Your team's primary focus is...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Turner & Townsend (Columbus, OH)
- …culture. Our clients value our proactive approach, depth of expertise, integrity and the quality we deliver. As a result, our people get to enjoy working on some ... the high-level strategic direction of project controls including cost management, risk management and schedule management. + Responsible for project budget approval… more
- Zurich NA (Cleveland, OH)
- …management including utilizing data analytics to inform strategy, stewarding underwriting quality , and partnering in tool & product innovation efforts. This position ... closely with leadership and various internal stakeholders to deliver comprehensive risk transfer solutions including primary & excess casualty, property, and other… more
- OhioHealth (Columbus, OH)
- …RAC program development and quality improvement process to ensure quality outcomes and mitigate financial risk . **Minimum Qualifications:** Associate's ... set of organizational skills, medical chart review and analysis, knowledge of claims appeal process and ability to apply (Interqual, Milliman) practice management… more
- Sedgwick (Columbus, OH)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... disclosures, and state-level insurance regulations + Participate in coaching, quality reviews, and process improvement initiatives **ADDITIONAL FUNCTIONS and… more
- Evolent (Columbus, OH)
- …on organizational performance and patient health. This role supports capitated risk and value-based strategy development, medical cost management activity, medical ... capabilities and processes related to the development/underwriting of capitated risk proposals including cost & use projections, trend selection/development, and… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …Domestic Collections - Responsible for processing and decisioning fraud check dispute claims . Includes working alerts, dispute cases and inbound call inquiries ... leadership in developing policies and procedures to enhance processes and reduce fraud risk . Responsible and accountable for risk by openly exchanging ideas and… more
- Exl Service (Dayton, OH)
- Overview Commercial Insurance Inspector - Independent Contractor Overview EXL Risk Control is a leading provider of risk assessments and loss control surveys to ... excellent communication skills, computer proficiency, and a commitment to meeting client quality and timeliness standards. Those with these skills as well as… more
- Molina Healthcare (Akron, OH)
- …management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, ... Management program and action plan, which includes strategies that ensure a high quality of patient care, ensuring that patients receive the most appropriate care at… more