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Lead provider relations and contracting strategies in Ohio, ensuring compliance and optimal performance while collaborating with stakeholders to enhance healthcare delivery.

The Customer Account Manager oversees customer account management, driving revenue growth and enhancing service utilization while collaborating with multiple teams and managing training and implementations.

The Payment Cycle Analyst II provides analytical support for claims-related projects, ensuring accuracy in claim payments, conducting data analysis, and documenting clinical and payment policies.

The AVP, Network and Contracting oversees provider contracting and network strategy, ensuring compliance and optimizing member access while leading a high-performing team.

The Revenue Cycle Coordinator III ensures timely resolution of member complaints related to eligibility and billing, leads teams, and develops training for compliance with regulatory standards.

The Operations Specialist III provides analytical support for claims projects, leads initiatives, reviews claims, and develops policies for claims processing.

The Operations Specialist II provides analytical support for Claims projects, assists in training staff, resolves provider issues, and analyzes claims data.

The Claims Management Analyst III leads eBusiness initiatives, manages EDI trading partners, ensures compliance, and analyzes performance for continuous improvement.

The Clinical Psychologist provides oversight for Behavioral Health coverage, develops clinical policies, participates in quality improvement, and ensures compliance with regulations while working with providers, members, and state agencies.

The Clinical Psychologist provides behavioral health coverage determination, ensuring appropriate care in a cost-effective setting. Responsibilities include patient safety, developing clinical policies, participating in quality improvement, and serving as a clinical liaison.