• Senior Clinical Vendor Partnerships…

    Medical Mutual of Ohio (Brooklyn, OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Builds and sustains ... to reconcile discrepancies and identify issues, proposes solutions, and escalates issues to senior leadership as needed. . Prepares and leads weekly, monthly, and ad… more
    Medical Mutual of Ohio (07/09/25)
    - Related Jobs
  • Senior Specialist , Member…

    Molina Healthcare (OH)
    …to working in the pacific time zone. **Job Duties** + Acts as a lead specialist to provide project, program , and/or initiative related direction and guidance for ... **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member intervention… more
    Molina Healthcare (07/31/25)
    - Related Jobs
  • Registered Nurse or Physical Therapist Denials…

    CenterWell (Columbus, OH)
    …caring community and help us put health first** The **Denials Management Specialist ** is responsible to respond to, monitor and analyze all governmental requests, ... administrative, supervisory, quality assurance or teaching position in/or related to a Medicare certified home health agency. + A thorough knowledge of federal… more
    CenterWell (07/30/25)
    - Related Jobs
  • Sr Specialist , Quality Interventions/QI…

    Molina Healthcare (Cleveland, OH)
    …accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance ... and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program -, and /...Healthcare. **Preferred Experience** + 1 year of experience in Medicare and in Medicaid. + Experience with data reporting,… more
    Molina Healthcare (08/02/25)
    - Related Jobs
  • Safety Quality Patient Experience…

    Cleveland Clinic (Garfield Heights, OH)
    …a rewarding, lifelong career in a diverse and welcoming environment. As a SQPE Specialist II, you will lead safety, quality and experience efforts by focusing on ... safety indicators, performing chart audits and preparing presentations. The SQPE Specialist will collaborate closely with emergency and neurology teams, engage staff… more
    Cleveland Clinic (07/18/25)
    - Related Jobs
  • Safety and Quality Patient Experience (SQPE)…

    Cleveland Clinic (Dover, OH)
    …technology and provide stellar patient care. The Safety and Quality Patient Experience Specialist II (SQPE) leads safety, quality, and experience work at our Union ... facility. The Specialist coordinates and implements improvement initiatives. The focus of...+ Build relationships with project teams, middle management, and senior sponsors. + Coach smaller improvement teams to success… more
    Cleveland Clinic (07/18/25)
    - Related Jobs
  • SQPE Specialist II

    Cleveland Clinic (Cleveland, OH)
    …care at one of the top healthcare organizations in the nation. As a SQPE Specialist II, you will lead safety, quality and experience efforts by focusing on tracking ... + Build relationships with project teams, middle management, and senior sponsors. + Coach smaller improvement teams to success...hire + Seven years of related SQPE, Performance Improvement Program or related healthcare experience OR four years of… more
    Cleveland Clinic (07/18/25)
    - Related Jobs
  • Field Medical Director, Interventional Cardiology…

    Evolent (Columbus, OH)
    …+ Not under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid, and is not identified as an "excluded ... Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the… more
    Evolent (07/30/25)
    - Related Jobs
  • Marketing Automation Manager (Adobe AEP/NBA)

    Humana (Columbus, OH)
    …Experience Platform (AEP) and Next Best Action (NBA) execution to join the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA ... eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Our… more
    Humana (07/24/25)
    - Related Jobs