Healthcare Resource Specialist Jobs in Cincinnati

Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..

Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..

Current UC employees must apply internally via SuccessFactors > http://bit.ly/UCEMPL   Founded in 1819, the University of Cincinnati embarks upon its third century - building on the past and defining the future ..

Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..

Qualifications nn n Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.nnBasic Requirements:nntCitizenship: Citizen ..

Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..

Description The Clinical Programs Pharmacy Technician Representative 2 integrates programs developed to improve overall health outcomes with a focus on prescription drugs. The Clinical Programs Pharmacy Technician Representative 2 performs varied ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Qualifications nn n Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.nnBasic Requirements:nntCitizenship: Citizen ..

Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..

CURRENT UC EMPLOYEES MUST APPLY INTERNALLY VIA SUCCESSFACTORS > HTTP://BIT.LY/UCEMPL   Founded in 1819, the University of Cincinnati puts education into action, ranking among the nation's best urban public research universities. Home ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..

Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..

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Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..

Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..

Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..

CURRENT UC EMPLOYEES MUST APPLY INTERNALLY VIA SUCCESSFACTORS > HTTP://BIT.LY/UCEMPL   Founded in 1819, the University of Cincinnati ranks among the nation's best urban public research universities. Home to more than 47,000 ..

... Certified Diabetes Care and Education Specialist-Remote-US in Cincinnati Ohio Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..