- Medical Mutual of Ohio (OH)
- …responsible for leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage ... **Responsibilities:** + Manages the implementation and operation of the Medical Mutual Medicare Compliance Program. + Serves as Medical Mutual's Medicare … more
- CVS Health (OH)
- …processes, procedures, and systems to ensure consistent results and organizational compliance with regulations related to the organization's Medicare Part ... with heart, each and every day. As the Senior Manager , Aetna Medical Pharmacy, you will be accountable for...business projects and programs and managing operations within the Medicare Part B Pharmacy Team. You will act as… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …value based contracts and gap closure work. This Population Health Clinical Quality Manager will support the Medicare Shared Savings Program (MSSP) value-based ... care model. **Primary Function/General Purpose of Position** The Manager of Population Health Clinical Quality is responsible for planning, directing, executing and… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Humana (Dayton, OH)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your… more
- Molina Healthcare (OH)
- …business areas and owners to ensure processes and reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with ... to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Cardinal Health (Columbus, OH)
- …of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. **_What is ... **_What Ethics & Compliance contributes to Cardinal Health_** Ethics & ...facility fee coding and auditing. + Expert-level knowledge of Medicare and Medicaid documentation and coding rules and guidelines;… more
- Elevance Health (Columbus, OH)
- ** Compliance Manager ** **Location:** This role requires associates to be in-office 1 - 2 days per week at one of our four Ohio offices (Cincinnati, Columbus, ... for employment, unless an accommodation is granted as required by law. The ** Compliance Manager ** is responsible for managing foundational and strategic … more
- Humana (Columbus, OH)
- …for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of Medicare ... and train a team of sales individuals. The Senior Manager , Medicare Sales, must have a solid...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Elevance Health (Columbus, OH)
- …of managerial experience is strongly preferred + Experience with IRE/Maximus and Medicare compliance , programs, guidelines, and processes are strongly preferred. ... ** Manager II Grievance/Appeals** **- Claims Support** **Office Locations:**...and operational and plan risk, ensures quality, and regulatory compliance . This role specifically oversees the IRE Team. **How… more
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