- 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
- Humana (Columbus, OH)
- …first** Humana Healthy Horizons is seeking a Senior Implementation Business Project Manager to manage a specific defined business area (non-IT) within Humana. This ... scope in the IT implementation activities. This is NOT a traditional Project Manager role. The Senior Implementation Business Project Manager will serve as… more
- CenterWell (Columbus, OH)
- …to obtain details necessary for prioritization (eg member experience improvements, compliance impacts, client goals, etc.) + Create project intake and prioritization ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Cardinal Health (Columbus, OH)
- …Summary Cardinal Health is seeking a driven, self-starter and highly skilled manager with expertise in healthcare regulatory compliance , including third party ... of Medicare and Medicaid billing and documentation requirements; healthcare compliance audit methodology, principles and techniques; CMS Medicare manuals;… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Senior Product Manager Conceives of, develops, delivers, and manages products for customer use. The Senior ... Product Manager work assignments involve moderately complex to complex issues...high-volume claims environments. + Partner closely with architecture, operations, compliance , and data teams to identify dependencies, mitigate risks,… more
- Molina Healthcare (Dayton, OH)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and state regulatory requirements are met for ... resolving complex business challenges that impact cost-containment and regulatory compliance . **Essential Job Duties** _Business Leadership & Operational Ownership_… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...+ Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with… more
- Gentiva (Independence, OH)
- …Inspire Excellence. Elevate Hospice Care.** We are seeking a Senior Patient Care RN Manager to join our hospice team. Reporting directly to the Executive Director or ... program by managing patient care activities, supervising clinical staff, and ensuring compliance with all company policies and regulatory standards. **As a Senior… more
- CenterWell (Columbus, OH)
- …Professional Practice will be responsible for pharmacy practice related compliance of CenterWell Pharmacy, encompassing Traditional, Specialty, and Community ... Market Vice President will work collaboratively with operational, legal, compliance , and engineering stakeholders to accomplish business initiatives while ensuring… more
- CenterWell (Columbus, OH)
- …of Health, Federal, and local agencies. + Oversee and manage Medicaid and Medicare enrollment, renewal, and compliance activities. + Track expiration dates and ... us put health first** As a Home Health Facility Licensure & Regulatory Compliance Analyst, you will be responsible to oversee facility licensing and certification… more