- Humana (Columbus, OH)
- …intake process and facilitate key Lean Portfolio Management (LPM) ceremonies for the Medicaid portfolio. The Lead Product Manager will be responsible for ... driving cross-functional collaboration, and managing vital meetings such as the Medicaid Triage and Product Standup. + Oversee, maintain, and continuously improve… more
- CVS Health (Columbus, OH)
- …every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health ... and enhance provider networks while meeting and exceeding accessibility, compliance , quality, and financial goals and cost initiatives. Collaborates… more
- Prime Therapeutics (Columbus, OH)
- …Come build the future of pharmacy with us. **Job Posting Title** Georgia Medicaid Clinical Account Manager - Remote **Job Description** Innovative business ... of the account, including P&L responsibility; and accountability for contract compliance .Accountable for developing and executing the strategic plan for their… more
- Humana (Columbus, OH)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as...EAPG + 2+ years of experience with Optum Rate Manager + 2+ years of experience with Optum WebStrat… more
- OhioHealth (Columbus, OH)
- …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 responsible for… 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)
- …trains employees across the organization, and conducts investigations to resolve ethics and compliance issues. ** Compliance Audit Manager ** Reporting to the ... the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff.… more
- Medical Mutual of Ohio (OH)
- …leading the implementation and day-to-day management of Medical Mutual's Medicare Compliance Program, which supports both Medicare Advantage and Medicare Supplement ... products. Reporting directly to the Chief Compliance Officer, the role ensures adherence to regulatory requirements through the development of policies, delivery of… more
- Prime Therapeutics (Columbus, OH)
- …school or equivalent GED required + 6 years work experience in Medicaid , Compliance , or Contract Administration Management or related industry experience ... career? Come build the future of pharmacy with us. **Job Posting Title** Manager Rebate Contract Management - Remote **Job Description** The Manager of… more
- Molina Healthcare (Dayton, OH)
- …goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits and ... resolving complex business challenges that impact cost-containment and regulatory compliance . **Essential Job Duties** _Business Leadership & Operational Ownership_… more