- Humana (Columbus, OH)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- OhioHealth (Columbus, OH)
- …This position will be responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is ... projects as assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining...Hospice. Projects as assigned by Director of Revenue and Reimbursement and Manager of Reimbursement . Provide… more
- Molina Healthcare (OH)
- …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Provider Engagement Executive develops and grows positive, long-term relationships with physicians, ... performance within the contracted working relationship with the health plan. The Provider Engagement Executive works on problems of diverse scope and complexity… more
- Somatus (Cleveland, OH)
- …country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious ... of 3 weeks' Vacation (PTO) + Professional Development, CEU, and Tuition Reimbursement + Curated Wellness Benefits supporting teammates physical and mental well-being… more
- Bon Secours Mercy Health (Lorain, OH)
- …eligibility for care; understand and communicates Center for Medicare & Medicaid Services (CMS) medical necessity and admission criteria. Establishes rapport with ... hospital staff and physicians; serves as consultant/resource person for...(ELOS) appropriately (using insurance and industry guidelines). Qualified to provide thorough and detail-oriented assessment of patient needs and… more
- OhioHealth (Columbus, OH)
- …resource person to campus leaders for research on new technology, alternate reimbursement methodologies, and non- hospital settings. Usually requires incumbent to ... proactive management of the charge masters and fee schedules for OhioHealth hospital operations covering 1000+ departments at all hospitals with patient charges of… more
- Somatus (Cincinnati, OH)
- …country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious ... of 3 weeks' Vacation (PTO) + Professional Development, CEU, and Tuition Reimbursement + Curated Wellness Benefits supporting teammates physical and mental well-being… more
- Centene Corporation (Fairlawn, OH)
- …Manager (RN) for our Buckeye Health Plan, supporting the MyCare Ohio MMP (Medicare- Medicaid Plan) Duals Program.** **This is a hybrid position covering the Northeast ... a preference for those who have worked with individuals in a home and hospital setting.** **Work hours are Monday through Friday, 8:00 AM to 5:00 PM.** **Position… more
- ProMedica Health System (Toledo, OH)
- …of metrics for financial success; patient satisfaction; access; physician, provider , and employee engagement; quality/safety; primary care membership growth. ... the EHR by physicians, APPs, and staff of PPG. Enhances physician and provider knowledge of available clinical services and actively works to coordinate and enhance… more