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Results based on filters ( 337 jobs found )

Associate Specialist, Appeals & Grievances

Molina Healthcare
Cincinnati, OH
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JOB DESCRIPTION Job SummaryProvides entry level support for claims ...
Details
Summary
About the job:
activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).**Essential Job Duties**- Enters denials and requests for appeals into information system and prepares documentation for further review.- Researches claims issues utilizing systems and other available resources.- Assures timeliness and appropriateness of appeals...
Location:
Cincinnati, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries and Administrative Assistants
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Manager, Health Management (Remote)

Molina Healthcare
Cincinnati, OH
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JOB DESCRIPTION Job SummaryProvides support for health management activities ...
Details
Summary
About the job:
within the care management/care coordination functions. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum, including behavioral health, long-term care, and population health-related education and services for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.Essential Job Duties- Based on clinical assessment and member reported...
Location:
Cincinnati, OH
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
US.jobs
Certifications / Licenses:
Certified Case Manager
Licensed Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead Analyst, Healthcare (Remote)

Molina Healthcare
Cleveland, OH
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**JOB DESCRIPTION****Job Summary**Performs research and analysis of complex ...
Details
Summary
About the job:
healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.**KNOWLEDGE/SKILLS/ABILITIES**+ Provides healthcare analysis including quantification and analysis of health care costs, development and maintenance of databases and other sources of information for quality initiatives, accreditation efforts, and regulatory mandates,...
Location:
Cleveland, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Associate Specialist, Appeals & Grievances

Molina Healthcare
Cleveland, OH
Actions
Apply
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JOB DESCRIPTION Job SummaryProvides entry level support for claims ...
Details
Summary
About the job:
activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).**Essential Job Duties**- Enters denials and requests for appeals into information system and prepares documentation for further review.- Researches claims issues utilizing systems and other available resources.- Assures timeliness and appropriateness of appeals...
Location:
Cleveland, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries and Administrative Assistants
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Associate Specialist, Appeals & Grievances

Molina Healthcare
Ohio
Actions
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JOB DESCRIPTION Job SummaryProvides entry level support for claims ...
Details
Summary
About the job:
activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).**Essential Job Duties**- Enters denials and requests for appeals into information system and prepares documentation for further review.- Researches claims issues utilizing systems and other available resources.- Assures timeliness and appropriateness of appeals...
Location:
Ohio
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries and Administrative Assistants
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead Analyst, Healthcare (Remote)

Molina Healthcare
Akron, OH
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**JOB DESCRIPTION****Job Summary**Performs research and analysis of complex ...
Details
Summary
About the job:
healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.**KNOWLEDGE/SKILLS/ABILITIES**+ Provides healthcare analysis including quantification and analysis of health care costs, development and maintenance of databases and other sources of information for quality initiatives, accreditation efforts, and regulatory mandates,...
Location:
Akron, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Associate Specialist, Appeals & Grievances

Molina Healthcare
Columbus, OH
Actions
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JOB DESCRIPTION Job SummaryProvides entry level support for claims ...
Details
Summary
About the job:
activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).**Essential Job Duties**- Enters denials and requests for appeals into information system and prepares documentation for further review.- Researches claims issues utilizing systems and other available resources.- Assures timeliness and appropriateness of appeals...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries and Administrative Assistants
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead Analyst, Healthcare (Remote)

Molina Healthcare
Ohio
Actions
Apply
Save to My Profile
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Report this job
**JOB DESCRIPTION****Job Summary**Performs research and analysis of complex ...
Details
Summary
About the job:
healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.**KNOWLEDGE/SKILLS/ABILITIES**+ Provides healthcare analysis including quantification and analysis of health care costs, development and maintenance of databases and other sources of information for quality initiatives, accreditation efforts, and regulatory mandates,...
Location:
Ohio
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Manager, Health Management (Remote)

Molina Healthcare
Cleveland, OH
Actions
Apply
Save to My Profile
See all jobs from this company
See who you know on LinkedIn
Report this job
JOB DESCRIPTION Job SummaryProvides support for health management activities ...
Details
Summary
About the job:
within the care management/care coordination functions. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum, including behavioral health, long-term care, and population health-related education and services for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.Essential Job Duties- Based on clinical assessment and member reported...
Location:
Cleveland, OH
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
US.jobs
Certifications / Licenses:
Certified Case Manager
Licensed Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Manager, Health Management (Remote)

Molina Healthcare
Dayton, OH
Actions
Apply
Save to My Profile
See all jobs from this company
See who you know on LinkedIn
Report this job
JOB DESCRIPTION Job SummaryProvides support for health management activities ...
Details
Summary
About the job:
within the care management/care coordination functions. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum, including behavioral health, long-term care, and population health-related education and services for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.Essential Job Duties- Based on clinical assessment and member reported...
Location:
Dayton, OH
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
US.jobs
Certifications / Licenses:
Certified Case Manager
Licensed Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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