• Senior Medicaid & Medicare

    OhioHealth (Columbus, OH)
    …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
    OhioHealth (09/25/25)
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  • Medicaid Provider Hospital…

    Humana (Columbus, OH)
    …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG,… more
    Humana (12/18/25)
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  • Sr. Medicare (PPS) Provider Hospital…

    Humana (Columbus, OH)
    … Business Intelligence Engineer will develop and maintain expertise in complex Medicare reimbursement methodologies. This role is within the Integrated Pricing ... on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement /editing logic and Humana system logic **Use your skills… more
    Humana (12/19/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Columbus, OH)
    Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare more
    Elevance Health (12/17/25)
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  • Senior Manager, MarketPoint Sales - Raleigh…

    Humana (Columbus, OH)
    …looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ... motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
    Humana (12/14/25)
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  • Provider Contracting Senior Manager,…

    CVS Health (Columbus, OH)
    …speed to market and to support segment leaders with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. **You will make an impact by:** ... heart, each and every day. **Position Summary** Aetna is recruiting for a Senior Manager, Value Based Contractor who will partner with business development and… more
    CVS Health (11/30/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Columbus, OH)
    …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and… more
    Molina Healthcare (10/31/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Columbus, OH)
    …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... skills required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and… more
    Molina Healthcare (10/25/25)
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  • Senior Analyst, Business

    Molina Healthcare (Columbus, OH)
    …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development… more
    Molina Healthcare (12/17/25)
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  • Senior Corporate Compliance Consultant-…

    Baylor Scott & White Health (Columbus, OH)
    …in a timely way. . Responds to inquiries and guidance requests utilizing applicable Medicare and Medicaid rules and regulations. Serves as a compliance resource ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
    Baylor Scott & White Health (12/19/25)
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