Current jobs related to Medicaid Provider Operations Specialist - Columbus, Ohio - CVS

  • Medicaid Claims Specialist

    2 weeks ago

    Columbus, Ohio, United States Alvis Full time

    Medicaid Billing Specialist RoleWe are seeking a dedicated Medicaid Billing Specialist to support our team at Alvis. This role involves managing financial and contract activities for individuals with intellectual and/or developmental disabilities.Key Responsibilities:Assist with Medicaid billing and general accounting functionsProvide client advocacy and...

  • Medicaid Claims Specialist

    4 weeks ago

    Columbus, Ohio, United States Alvis Full time

    Medicaid Billing SpecialistWe are seeking a highly skilled Medicaid Billing Specialist to join our team at Alvis. As a key member of our financial services team, you will be responsible for managing financial and contract activities for individuals with intellectual and/or developmental disabilities.Key Responsibilities:Assist with the management of...

  • Medicaid Claims Specialist

    4 weeks ago

    Columbus, Ohio, United States Alvis Full time

    Medicaid Billing Specialist RoleWe are seeking a skilled Medicaid Billing Specialist to join our team at Alvis. This role is responsible for managing financial and contract activities for individuals with intellectual and/or developmental disabilities.Key Responsibilities:Assist with the management of financial activities for individuals with intellectual...

  • Medicaid Data Support Specialist

    2 weeks ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job Title: Medicaid Data Support SpecialistJob Summary:The Medicaid Data Support Specialist will provide technical support to the Medicaid program by analyzing and interpreting data to inform program decisions. The ideal candidate will have strong analytical skills, excellent communication skills, and the ability to work effectively in a team environment.Key...

  • Business Analyst

    2 weeks ago

    Columbus, Ohio, United States MAXIMUS Full time

    Job Title: Business Analyst - Medicaid SpecialistWe are seeking a skilled Business Analyst with a strong analytical mindset to transform user needs into actionable operational solutions. In this role, you will dive deep into our systems, driving improvements that enhance program performance and ensure compliance with Medicaid standards.Key...

  • Strategic Leader for Medicaid Provider Services

    1 week ago

    Columbus, Ohio, United States Humana Full time

    Job DescriptionHumana is seeking an experienced Associate Director to lead our Medicaid Provider Services team. As a key member of our Corporate Medicaid segment, you will be responsible for developing and implementing strategic plans to drive optimal provider experience and performance.Key Responsibilities:Lead a dynamic team responsible for developing and...

  • Medicaid Health Systems Specialist

    2 weeks ago

    Columbus, Ohio, United States State of Ohio Full time

    Job SummaryAs a Medicaid Health Systems Specialist with the State of Ohio, you will play a critical role in ensuring the effective delivery of Medicaid services to eligible individuals. This position requires strong analytical and communication skills, as well as the ability to work collaboratively with various stakeholders.Key ResponsibilitiesMonitor and...

  • Compliance Specialist for Medicaid Health Systems

    2 weeks ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryWe are seeking a skilled Compliance Specialist to join our team at the Ohio Department of Medicaid. The successful candidate will be responsible for ensuring compliance with Medicaid health systems regulations and guidelines.Key ResponsibilitiesDevelop and implement compliance programs to ensure adherence to Medicaid regulationsConduct regular...

  • Authorization Review Nurse

    2 months ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryThe Ohio Department of Medicaid is seeking a skilled Clinical Authorization Review Nurse to join our team as a Medicaid Health Systems Specialist - RN. As a key member of our organization, you will be responsible for reviewing and authorizing medical services to ensure compliance with Medicaid regulations.Key ResponsibilitiesConduct thorough...

  • Medicaid Eligibility Specialist

    3 weeks ago

    Columbus, Ohio, United States St. Francis Full time

    Medicaid Eligibility Advocate Job SummaryWe are seeking a highly motivated and detail-oriented Medicaid Eligibility Advocate to join our team at St. Francis. As a Medicaid Eligibility Advocate, you will play a critical role in ensuring that patients receive the financial assistance they need to access quality healthcare services.Key Responsibilities:Conduct...

  • Clinical Authorization Review Nurse

    4 weeks ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryThe Ohio Department of Medicaid is seeking a skilled Clinical Authorization Review Nurse to join our team as a Medicaid Health Systems Specialist - RN. As a key member of our organization, you will be responsible for reviewing and authorizing medical services to ensure compliance with Medicaid regulations.Key ResponsibilitiesConduct thorough...

  • External Auditor

    2 months ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryWe are seeking a skilled External Auditor to join our team at the Ohio Department of Medicaid. As a Hybrid Auditor, you will be responsible for conducting audits and providing recommendations to improve the efficiency and effectiveness of our programs.Key ResponsibilitiesConduct audits of Medicaid programs to ensure compliance with state and...

  • Compliance and Safety Check Nurse/Reviewer for Medicaid Health Systems Specialist

    1 week ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job Summary We are seeking a skilled RN Compliance and Safety Check Specialist to join our team at the Ohio Department of Medicaid. As a key member of our team, you will be responsible for ensuring the highest level of compliance and safety in our Medicaid health systems. Key ResponsibilitiesConduct thorough compliance and safety checks to ensure adherence...

  • Medicaid Quality Improvement Manager

    3 weeks ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryWe are seeking a highly skilled Medicaid Quality Improvement Manager to join our team at the Ohio Department of Medicaid. As a key member of our organization, you will be responsible for ensuring the highest quality of care for Medicaid recipients.Key ResponsibilitiesDevelop and implement quality improvement initiatives to enhance the delivery of...

  • Medicaid Eligibility Specialist

    2 weeks ago

    Columbus, Ohio, United States St. Francis Full time

    About the RoleThe Medicaid Eligibility Advocate is a key member of our team at St. Francis, responsible for conducting eligibility screenings, assessing patient financial requirements, and counseling patients on insurance benefits and co-payments.This role is a liaison between the patient, hospital, and governmental agencies, actively involved in all case...

  • Medicaid Quality Improvement Manager

    4 weeks ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryWe are seeking a highly skilled Medicaid Quality Improvement Manager to join our team at the Ohio Department of Medicaid. As a key member of our organization, you will be responsible for ensuring the highest quality of care for Medicaid recipients.Key ResponsibilitiesDevelop and implement quality improvement initiatives to enhance the overall...

  • Senior Provider Education Specialist

    4 weeks ago

    Columbus, Ohio, United States Humana Full time

    Job Title: Senior Provider Education ProfessionalBecome a part of our caring community and help us put health firstHumana Healthy Horizons is seeking a Senior Medicaid Provider Education Professional to drive best-in-class provider experience for Humana's Medicaid segment. This professional will update content and complete an annual review of provider...

  • Clinical Authorization Review Nurse

    1 week ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryWe are seeking a skilled Clinical Authorization Review Nurse to join our team at the Ohio Department of Medicaid. As a Hybrid Clinical Authorization Review Nurse, you will be responsible for reviewing and authorizing medical services for Medicaid recipients. This is a full-time position with a competitive hourly rate of $31.86.Key...

  • County Engagement Manager

    4 weeks ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryWe are seeking a skilled County Engagement Manager to join our team at the Ohio Department of Medicaid. This is a full-time position that will work closely with county officials to develop and implement effective health administration strategies.Key ResponsibilitiesDevelop and maintain relationships with county officials to promote Medicaid health...

  • Operational Support Coordinator

    2 months ago

    Columbus, Ohio, United States Ohio Department of Developmental Disabilities Full time

    Job SummaryWe are seeking a highly skilled Project Support Specialist to join our team at the Ohio Department of Medicaid. As a key member of our team, you will provide operational and administrative support to our project management team.Key ResponsibilitiesProvide data analytics and project management support to our teamAssist in organizing and planning...

Medicaid Provider Operations Specialist

2 months ago

Columbus, Ohio, United States CVS Full time
About the Role

We are seeking a highly skilled Medicaid Provider Operations Specialist to join our team at CVS. In this role, you will be responsible for designing and implementing enterprise-wide solutions to address business problems.

Key Responsibilities
  • Develop and implement strategic initiatives to improve operational efficiency and effectiveness
  • Collaborate with cross-functional teams to identify and address business needs
  • Design and implement solutions to improve business processes and operations
  • Provide expert-level guidance and support to internal stakeholders
  • Stay up-to-date with industry trends and best practices to ensure CVS remains competitive
Requirements
  • Proven experience in Medicaid provider operations or a related field
  • Strong analytical and problem-solving skills
  • Excellent communication and collaboration skills
  • Ability to work in a fast-paced environment and prioritize multiple tasks
  • Strong understanding of business operations and process improvement