- Molina Healthcare (Covington, KY)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (Covington, KY)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Covington, KY)
- **Job Description** **Job Summary** Leads and directs Molina Medicare segment leaders who are responsible for the development and administration of Medicare ... **Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function… more
- Molina Healthcare (Covington, KY)
- …abilities; ability to handle multiple priorities and deal with ambiguity; provide oversight over the strategic and operational portfolios; manage strategic ... Program Management professional. Responsible for overall governance across all operational and strategic portfolio of projects; strong management and leadership… more
- Molina Healthcare (Covington, KY)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on ... specific to hospital revenue cycle risk areas highlighted by the OIG, Medicare , State Medicaid, State Insurance Fraud; Managed Care or Governmental Value-Based… more
- Molina Healthcare (Covington, KY)
- …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more
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