- CVS Health (Columbus, OH)
- …do it all with heart, each and every day. **Position Summary** The Lead Director, Provider Portal Strategy & Operations is responsible for the strategic leadership ... three primary provider portal solutions: Availity Commercial/Medicare Portal, Availity Medicaid Portal, and DentalXchange Dental Portal. This role partners with… more
- Centene Corporation (Columbus, OH)
- …improves member health outcomes, and aligns with Centene and the Ohio Department of Medicaid . + Lead population health initiatives with a strong focus on ... person at a time. As an Executive on our team , you could be the one who changes everything...the direction of Centene and the Ohio Department of Medicaid . While the primary focus is on Medicaid… more
- Elevance Health (Columbus, OH)
- …are seeking an experienced and proactive Project Liaison to join our team . This critical role involves managing incident reporting, developing prevention plans, ... and restraint management, and handling related reporting to the Ohio Department of Medicaid (ODM). The ideal candidate will have a strong background in compliance,… more
- Elevance Health (Columbus, OH)
- …We are seeking a dedicated and experienced Provider Success Consultant to join our team and drive the achievement of value-based care in the Medicare, Medicaid , ... and optimizing quality and cost performance. + **Collaboration and Facilitation:** Lead collaborative meetings with provider staff and internal stakeholders to… more
- CVS Health (Columbus, OH)
- …Aetna is looking for a medical director to be part of a centralized team that supports the Medical Management staff ensuring timely and consistent responses to ... medical director will participate in and be able to lead daily rounds. **Required Qualifications:** Minimum 3-5 years of...+ years of experience in managed care (Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS… more
- Sumitomo Pharma (Columbus, OH)
- …the patients and their families. This person must enjoy working within a high-functioning team with the goal to help everyone succeed for the benefit of the patients ... various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove reimbursement barriers to treatment + Build and maintain strong… more
- Trinity Health (Columbus, OH)
- …accordance with Federal regulatory requirements and the Centers for Medicare and Medicaid Services (CMS). Responsible for ensuring the eligibility , demographic ... into a special payment status category. Responsible for all eligibility and membership functions relating to enrollment, disenrollment, special...come alive, we invite you to consider joining our team . Here, care is provided by all of us… more
- Capgemini (Cincinnati, OH)
- … Medicaid or Exchange program/ product build knowledge (Enrollment, Eligibility , Claims, Provider network, encounters etc) (Highly Recommended having exposure to ... high complexity programs Responsible for overall delivery of project Lead stakeholders in the refinement of the project charter...onsite State Readiness reviews Work with the Project Management team to develop and present status at weekly project… more
- Cardinal Health (Columbus, OH)
- …messages on an hourly basis. + Mentors new hires; assists + Assists management and team lead with motivating and coaching employees to succeed as needed. + ... and properly resolves by follow-up & disposition. + Verifies patient eligibility with secondary insurance company when necessary. + Bills supplemental insurances… more
- Elevance Health (Columbus, OH)
- …with members, care coordinators, providers and members of the interdisciplinary care team to complete prevention planning and mitigate risks. + Ensures medically ... **Preferred Skills, Capabilities and Experiences:** + Experience working in Ohio Dept of Medicaid 's Incident Management System is strongly preferred. + AS or BS in… more