Senior Installation Administration Professional

43201 Columbus, Ohio Humana

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**Become a part of our caring community and help us put health first**
The Senior Installation Administration Professional establishes and manages relationships with internal and external clients. Coordinates end to end process from the point of sale to members loaded in system, ID cards issued, claims opened for processing and certifications issued. The Senior Installation Administration Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
**Job Description**
The Senior Installation Administration Professional creates accurate and timely reporting of implementation data, status, and metrics. Serves as the control point for all requirements gathering and dissemination of information to functional areas. Leads post-implementation stabilization process, if applicable. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Responsibilities**
· Overall accountability for the end-to-end implementation process from point of sale to go-live
· Capable of prioritizing and balancing multiple responsibilities and projects, pivoting where necessary
· Implement strategies to streamline processes with a focus on achieving measurable improvements in key performance indicators
· Facilitates innovative client solutions for unique group setup
**Use your skills to make an impact**
**Required Qualifications**
· Bachelor's degree or 3 years equivalent healthcare experience
· Previous relationship management experience
· Experience implementing, managing, or consulting on accounts from 10-100,000 lives/retirees
· Ability to effectively communicate with leadership and peers, inside and outside the organization, both verbal and written
· Project or process management experience
· Proficient with Microsoft suite to include proficiency with Excel (sort pivot tables, compare excel files systematically, etc.)
· Ability to utilize analytical thinking and determine root cause(s) and recommended solution(s) as well as identify trends for preventative action
· Analytical thinker with success in introducing new processes and/or process improvements in operational environments
**Preferred Qualifications:**
· Group Medicare knowledge
· Self-starter who takes initiative, ownership and anticipates future trends accurately
**Additional Information**
Travel 20-25%
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 07-18-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
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**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
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Lease Administration Senior Analyst

43201 Columbus, Ohio CBRE

Posted 9 days ago

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Job Description

Lease Administration Senior Analyst
Job ID
225887
Posted
23-Jun-2025
Service line
Advisory Segment
Role type
Full-time
Areas of Interest
Property Management
Location(s)
Columbus - Ohio - United States of America, Dallas - Texas - United States of America, Des Moines - Iowa - United States of America, Houston - Texas - United States of America, Indianapolis - Indiana - United States of America, Kansas City - Missouri - United States of America, Louisville - Kentucky - United States of America, Omaha - Nebraska - United States of America, Saint Louis - Missouri - United States of America
**About the Role:**
As a CBRE Lease Administration Senior Analyst, you will be responsible for conducting reconciliations for large clients to ensure operating expenses follow lease terms.
This job is a part of the Lease Administration functional area which focuses on providing real estate portfolio administration, database management, accounts payable and receivable, and audit services.
**What You'll Do:**
+ Compare and evaluate operating expense and tax reconciliation statements received. Verify the expenses charged to clients following lease clauses.
+ Perform full-scope advanced audits for lease administration clients. Request additional information and recommend action for additional audit and recovery.
+ Prepare complex reports of findings and ensure accurate credits and appropriate charges are made and recorded.
+ Prepare CAM reconciliations for accuracy and adherence to business control standards and guidelines.
+ Review high-value contracts to properly identify fees. This includes sharing audit savings, travel reimbursements, etc.
+ Apply general knowledge of standard principles and techniques/procedures to accomplish assigned tasks and solve routine problems.
+ Have a broad knowledge of own job discipline and some knowledge of several job disciplines within the function.
+ Lead by example and model behaviors that are consistent with CBRE RISE values. May convince to reach an agreement.
+ Impact the quality of own work and the work of others on the team.
+ Work primarily within standardized procedures and practices to achieve objectives and meet deadlines.
+ Explain complex information to others in straightforward situations.
+ Heavy administrative and accounting skills are a plus.
**What You'll Need:**
_To perform this job successfully, an individual will need to perform each crucial duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required._
_Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions._
+ Bachelor's Degree preferred with 2-5 years of relevant experience. In lieu of a degree, a combination of experience and education will be considered.
+ Understanding of existing procedures and standards to solve slightly complex problems.
+ Ability to analyze possible solutions using technical experience to apply appropriate judgment and precedents.
+ In-depth knowledge of Microsoft Office products. Examples include Word, Excel, Outlook, etc.
+ Strong organizational skills with an inquisitive mindset.
**Why CBRE?**
When you join CBRE, you become part of the global leader in commercial real estate services and investment that helps businesses and people thrive. We are dynamic problem solvers and forward-thinking professionals who create significant impact. Our collaborative culture is built on our shared values - respect, integrity, service and excellence - and we value the diverse perspectives, backgrounds and skillsets of our people. At CBRE, you have the opportunity to realize your full potential.
**Our Values in Hiring**
At CBRE, we are committed to fostering a culture where everyone feels they belong. We value diverse perspectives and experiences, and we welcome all applications.
**Disclaimers**
Applicants must be currently authorized to work in the United States without the need for visa sponsorship now or in the future.
**Equal Employment Opportunity:** CBRE has a long-standing commitment to providing equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, pregnancy, age, citizenship, marital status, disability, veteran status, political belief, or any other basis protected by applicable law.
**Candidate Accommodations:** CBRE values the differences of all current and prospective employees and recognizes how every employee contributes to our company's success. CBRE provides reasonable accommodations in job application procedures for individuals with disabilities. If you require assistance due to a disability in the application or recruitment process, please submit a request via email at or via telephone at +1 (U.S.) and +1 (Canada).
CBRE, Inc. is an Equal Opportunity and Affirmative Action Employer (Women/Minorities/Persons with Disabilities/US Veterans)
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University Lecturer (Business Administration)

43201 Columbus, Ohio $70000 Annually WhatJobs

Posted 15 days ago

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Job Description

full-time
Our client, a prestigious university with a highly-ranked School of Business, is seeking a dynamic and engaging University Lecturer in Business Administration to join their faculty in Columbus, Ohio, US . This full-time position offers an exciting opportunity for an experienced professional or academic to share their expertise, inspire the next generation of business leaders, and contribute to a vibrant academic community. The ideal candidate will possess a strong command of various business disciplines, excellent teaching skills, and a commitment to student success.

Responsibilities:
  • Develop and deliver high-quality lectures, seminars, and workshops in core and specialized areas of Business Administration, such as Management, Marketing, Finance, Human Resources, or Operations.
  • Design and update course syllabi, learning materials, assignments, and assessments to ensure a rigorous and relevant curriculum.
  • Create an engaging and interactive learning environment that fosters critical thinking, practical application, and collaborative learning among undergraduate and/or graduate students.
  • Evaluate student performance through grading assignments, exams, and projects, providing constructive feedback for academic growth.
  • Hold regular office hours to provide academic support, mentorship, and guidance to students.
  • Participate in departmental and university meetings, committees, and academic events.
  • Contribute to the ongoing development and improvement of the Business Administration curriculum.
  • Stay current with advancements and best practices in the field of Business Administration through continuous learning and professional development.
  • Collaborate with colleagues on interdisciplinary projects and research initiatives where appropriate.
  • Advise students on academic pathways, career opportunities, and professional development.
  • Utilize learning management systems (LMS) and other educational technologies effectively to enhance teaching and learning.
  • Maintain professional conduct and adhere to all university policies and ethical guidelines.
  • Foster a diverse and inclusive classroom environment that respects varied perspectives and backgrounds.

Qualifications:
  • Master's degree (MBA strongly preferred) or Ph.D. in Business Administration or a closely related field from an accredited institution.
  • Minimum of 3-5 years of professional experience in a relevant business sector, or equivalent teaching experience at the university level.
  • Demonstrated excellence in teaching and a strong commitment to student learning.
  • Expertise in at least one core area of Business Administration (e.g., Marketing, Finance, Management, Strategy).
  • Excellent oral and written communication skills, with the ability to convey complex concepts clearly and engagingly.
  • Strong interpersonal skills and the ability to connect effectively with students and colleagues.
  • Ability to work effectively both independently and collaboratively within an academic setting.
  • Familiarity with current educational technologies and online learning platforms.
  • A record of scholarly activity or industry publications is a plus.

Our client offers a competitive salary, comprehensive benefits package including health insurance, retirement plans, and tuition benefits, along with a supportive academic environment that values intellectual curiosity and professional growth. Join a community dedicated to shaping the future of business leadership. If you are a passionate educator ready to inspire and empower students, we encourage you to apply.
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Specialist, Provider Network Administration - Remote

43224 Columbus, Ohio Molina Healthcare

Posted 1 day ago

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JOB DESCRIPTION

Job Summary

Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.

KNOWLEDGE/SKILLS/ABILITIES

  • Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.

  • Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.

  • Audits loaded provider records for quality and financial accuracy and provides documented feedback.

  • Assists in configuration issues with Corporate team members.

  • Assists in training current staff and new hires as necessary.

  • Conducts or participates in special projects as requested.

JOB QUALIFICATIONS

Required Education

Associate degree in Business or equivalent combination of education and experience

Required Experience

  • Min. 3 years managed care experience

  • Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.

  • Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.

Preferred Education

Bachelor's Degree

Preferred Experience

  • 3+ years Provider Claims and/or Provider Network Administration experience

  • Experience in Medical Terminology, CPT, ICD-9 codes, etc.

  • Access and Excel - intermediate skill level (or higher)

  • Credentialing Knowledge

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $21.16 - $42.2 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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Director, System Engineer and Administration

43224 Columbus, Ohio Pansophic Learning

Posted 20 days ago

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About the Opportunity

"We believe that every child should be able to be anything they want in life, regardless of their birthplace and circumstances." - Ron Packard, CEO & Founder

Pansophic Learning is an education company that strives to provide students and educators exceptional learning solutions that enable them to maximize their success academically and in life, regardless of geographic, financial, or demographic circumstance. These learning solutions include high quality content, technology, teaching and exceptional schools.

The Director System Engineering and Administration is responsible for designing, managing, administering, and monitoring applications integral to our business partners, our products, and the Information Technology (IT) organization. We are looking for a passionate IT Leader with a large spectrum of experience working across multiple business verticals in a rapidly evolving environment. You will have the opportunity to improve everyday business processes, challenge the status quo and propose innovative solutions to modernize our approach in areas covering forecasting, asset management, procurement, and financial reconciliation.

THIS IS AN ON-SITE ROLE

As the Director, Engineering and Administration you will support the following areas:
  • Account creation, automation, and support for Google, Windows, and Azure enterprise and education environments
  • Support and implementation of Windows engineering items to include Intune, MFA, DLP, Cloud App Security, Defender ATP and Defender Endpoint
  • Support for large environments focused on automation and software patching
  • Work with platforms such as GoGuardian, Printix, Radius, Exchange, Intune, Jamf, and V2
  • Ensure products meet the necessary requirements for security, portability, and performance
  • Meet tight business timelines, establish and measure required SLAs
  • Create and maintain required documentation
  • Develop, deploy, and support processes to support data projects
  • Build strategic partnerships with vendors and hold them accountable for delivery
  • Operational support, logging, alerting, and establishing tools, standards, and operational procedures
  • Work across a multitude of third-party solution providers each fulfilling a portion of the overall service delivery
  • Exhibit critical thinking by seeing outcomes and providing direction when there are multiple stakeholders and solutions
  • Ensure concise, clear, and regular verbal and written communication between business partners and the IT organization
  • Adhere to established standards by the IT organization
About You:
  • Bachelor's degree or equivalent experience
  • Highly organized, able to multi-task, with a high attention to detail and ability to prioritize
  • Confident, high-energy, self-motivated and a true team player
  • Successful individuals will be innovative, persuasive, creative and have a genuine curiosity in their business partner's business, goal and results oriented, optimistic, smart, value-added mindset, proactive and easily adapts to change
  • Exceptional ability to communicate and foster positive business relationships
  • Accountability and personal organization are essential
  • Demonstrate leadership qualities and abilities
  • Ability to establish milestones and ensure execution is on track
  • Ability to analyze and optimize existing processes
  • Ability to mediate, counsel, and empathize with internal and external teams to ensure expectations are exceeded
  • Experience working with senior and executive level business partners
  • Patient and active listener
  • Ability to pass federal and state criminal background checks (FBI/BCI)
  • Ability to think independently and contribute to the overall effort without much direction
Our Benefits:

Life benefits - time & peace of mind
  • Paid time off
  • Retirement contributions
  • Optional Basic Life and AD&D insurance
  • Voluntary life insurance (employee, spouse, child)
  • Discounted childcare at Early Learning Academies locations
Health benefits - stay well & thrive
  • Medical, dental, and vision insurance
  • Employee Assistance Program
  • Voluntary short-term disability insurance
  • Voluntary long-term disability insurance
Career benefits - keep growing
  • Career advancement opportunities throughout Pansophic Learning and our strong network of 4,000+ instructors and education professionals

EQUAL EMPLOYMENT OPPORTUNITY

It is our policy to abide by all federal, state and local laws prohibiting employment discrimination based solely on a person's race, color, religious creed, sex, national origin, ancestry, citizenship status, pregnancy, childbirth, physical disability, mental and/or intellectual disability, age, military status, veteran status (including protected veterans), marital status, registered domestic partner or civil union status, familial status, gender (including sex stereotyping and gender identity or expression), medical condition, genetic information, sexual orientation, or any other protected status except where a reasonable, bona fide occupational qualification exists.

#INDCORP

#: #LI-KM2
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Sr. Manager, Medicaid Contract Administration

43201 Columbus, Ohio Sumitomo Pharma

Posted 7 days ago

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Job Description

Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the U.S. (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma Canada, Inc.) and Europe (Sumitomo Pharma Switzerland GmbH) focused on addressing patient needs in oncology, urology, women's health, rare diseases, psychiatry & neurology, and cell & gene therapies. With several marketed products in the U.S., Canada, and Europe, and a diverse pipeline of early- to late-stage assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website ( or follow us on LinkedIn ( .
**Job Overview**
We are currently seeking a dynamic, highly motivated, and experienced individual for the position of Sr. Manager, Medicaid Contract Administration. This position is responsible for managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting Medicaid claims and dispute resolution with state agencies. This position requires a detailed understanding of the life science industry specific to the Medicaid payer landscape. The decisions made in this position affect company sales, pricing discounts, and best price implications. This role also facilitates working relationships with both internal and external customers.
**Job Duties & Responsibilities**
+ Lead operations person for all Medicaid decisions as it relates to Model N implementation and payment process.
+ Experience in processing Medicaid rebates preferably using Model N software application or other similar industry standard software.
+ Investigate, analyze information, and resolve business questions by applying information from various data sources, business rules and system processes.
+ Ability to understand and perform complex rebate and best price calculations.
+ Able to foster and maintain constructive working relationships with customers while resolving business issues dealing with data correctness.
+ Interact with internal departments (Internal Audit, Commercial Insights, Contracting, SOX Compliance, and Legal) to clarify policy compliance requirements and contract language clauses.
+ Keep current on regulatory and industry changes that may impact Medicaid operations.
+ Oversee the Medicaid Dispute Resolution process.
+ Keen attention to detail and ability to conduct repetitive transactions and processes using computer systems.
+ Identifies and resolves discrepancies in submitted data invoices to ensure legitimacy of contract discounts.
+ Ensures detailed accuracy of correct data input into company systems.
+ Maintains service standards in processing data submitted by customers and proactively advises management of issues.
+ Able to identify and recommend improvements in business procedures and outcomes.
+ Create and maintain ongoing SOP documentation for department processes and confirm adherence to final policies and system requirements.
+ Train staff on Medicaid landscape and Model N system navigation.
+ Manage a staff with a concentration on career development.
+ Performs other responsibilities as assigned.
**Key Core Competencies**
+ Six plus years' experience in the healthcare/pharmaceutical industry.
+ Knowledge and experience in common industry software programs (i.e., Model N).
+ Has experience in processing Medicaid rebates preferably using Model N software application or other similar industry standard software.
+ Able to investigate, analyze information, and resolve business questions by applying information from various data sources, business rules and system processes.
+ Proficient in MS Office (Word, Excel, Access, PowerPoint, MS Project, Visio, SharePoint).
+ Customer-focused ability to communicate across all levels of the organization.
+ Excellent written skills required.
+ Strong problem solving, critical thinking, communication, and sound judgment skills.
+ Solid experience in supporting System/application jobs and troubleshooting production issues in complex software solutions.
+ Fast paced environment handling multiple demands.
+ Must be able to exercise appropriate judgment as necessary.
+ Requires a high level of initiative and independence.
+ Strong attention to detail required.
+ High degree of organizational awareness, ability to connect the dots to understand all the interdependency and big picture.
**Education & Experience**
+ Minimum 8 - 12 (w/o Master's) or 6 - 8 years (with Master's) years of relevant experience in biotech or pharmaceutical industry.
The base salary range for this role is $153,920 to $192,400. Base salary is part of our total rewards package which also includes the opportunity for merit-based salary increases, short incentive plan participation, eligibility for our 401(k) plan, medical, dental, vision, life and disability insurances and leaves provided in line with your work state. Our robust time-off policy includes flexible paid time off, 11 paid holidays plus additional time off for a shut-down period during the last week of December, 80 hours of paid sick time upon hire and each year thereafter. Total compensation, including base salary to be offered, will depend on elements unique to each candidate, including candidate experience, skills, education and other factors permitted by law.
Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.
**Confidential Data** : All information (written, verbal, electronic, etc.) that an employee encounters is considered confidential.
**Compliance** : Achieve and maintain Compliance with all applicable regulatory, legal and operational rules and procedures, by ensuring that all plans and activities for and on behalf of Sumitomo Pharma America (SMPA) and affiliates are carried out with the "best" industry practices and the highest ethical standards.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
**Mental/Physical Requirements** : Fast paced environment handling multiple demands. Must be able to exercise appropriate judgment as necessary. Requires a high level of initiative and independence. Excellent written and oral communication skills required. Requires ability to use a personal computer for extended periods of time.
**Sumitomo Pharma America (SMPA)** **is an Equal Employment Opportunity (EEO) employer**
Qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.
Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the U.S. (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma Canada, Inc.) and Europe (Sumitomo Pharma Switzerland GmbH) focused on addressing patient needs in oncology, urology, women's health, rare diseases, psychiatry & neurology, and cell & gene therapies. With several marketed products in the U.S., Canada, and Europe, a diverse pipeline of early- to late-stage assets, and in-house advanced technology capabilities, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website ( or follow us on LinkedIn ( .
At Sumitomo Pharma America, our work is guided by the Sumitomo Pharma mission, vision and values, which tie closely to our company's cultural pillars.
**Our** **Mission**
_To broadly contribute to society through value creation based on innovative research and development activities for the betterment of healthcare and fuller lives of people_ _worldwide_
**Our** **Vision**
_For Longer and Healthier Lives, we unlock the future with cutting edge technology and_ _ideas_
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Specialist, Provider Network Administration - Remote

43201 Columbus, Ohio Molina Healthcare

Posted 9 days ago

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Job Description

**JOB DESCRIPTION**
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.
+ Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
+ Audits loaded provider records for quality and financial accuracy and provides documented feedback.
+ Assists in configuration issues with Corporate team members.
+ Assists in training current staff and new hires as necessary.
+ Conducts or participates in special projects as requested.
**JOB QUALIFICATIONS**
**Required Education**
Associate degree in Business or equivalent combination of education and experience
**Required Experience**
+ Min. 3 years managed care experience
+ Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
+ Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 3+ years Provider Claims and/or Provider Network Administration experience
+ Experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
+ Credentialing Knowledge
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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About the latest Administration Jobs in Canal Winchester !

IS Epic Database Administrator - Systems Administration

43224 Columbus, Ohio Nationwide Children's Hospital

Posted 9 days ago

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Overview:

The Epic Database Administrator is responsible for managing, monitoring and supporting the Cache, Clarity, and Caboodle Databases. The Epic Database Administrator I has basic understanding of system availability, security and performance of the Cache, Clarity, and Caboodle Databases and Epic related client system's software.

Epic Cache Administrator experience or certification strongly desired.

Epic Clarity Administrator experience or certification strongly desired.

Epic Caboodle Administrator experience or certification strongly desired.

Job Description Summary:

Administers, maintains, develops and implements policies and procedures for ensuring the security and integrity of company databases. Implements data models and database designs, data access and table maintenance codes; resolves database performance issues, database capacity issues, replication, and other distributed data issues.Ability to work on call schedules to meet job requirements; requires routine after-hours support and occasional overnight travel.

Job Description:

Essential Functions:
  • Designs and implements database structures and security measures to ensure data integrity and availability.
  • Monitors and optimizes database performance to ensure efficient data processing and retrieval. Detects, troubleshoots and resolves database related performance problems.
  • Installs and configures database software and related tools to support business operations. Maintains databases, installing patches and upgrades to database environments.
  • Establishes, maintains and monitors sound backup and recovery policies and procedures to minimize data loss in case of system failures. Sets up and maintains documentation and security control standards.
  • Collaborates with others to troubleshoot and resolve database-related issues. Manages database security, collaborating to determine appropriate database access needs; provides gatekeeper function for database access.
  • Keeps up-to-date with emerging trends and technologies in database management and suggests how to best leverage these new capabilities. Keeps up to date on DBA training and certifications.
  • Develops and maintains disaster recovery plans, routinely testing DR scenarios. Participates in capacity planning exercises to forecast database management requirements.

Education Requirement:

Bachelor's Degree in related Computer Science areas, or equivalent experience, required.

Licensure Requirement:

(not specified)

Certifications:

DBA Certification, preferred.

Skills:
  • Advanced skills in SQL, PL/SQL, database design, database tuning and performance optimization.
  • Exceptional interpersonal, presentation, and communication skills.

Experience:

Two years of experience as a Database Administrator, preferred.

Physical Requirements:

OCCASIONALLY: Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 0-10 lbs

FREQUENTLY: Decision Making

CONTINUOUSLY: Audible speech, Computer skills, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting

Additional Physical Requirements performed but not listed above:

(not specified)

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

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Director, Medicare Administration (Regulatory SME) - REMOTE

43201 Columbus, Ohio Molina Healthcare

Posted 3 days ago

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Job Description

**JOB DESCRIPTION**
**Job Summary**
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Establishes audit controls and measurements to ensure correct processes are established. Develops and performs internal audits/risk assessments, monitoring program for Molina Healthcare departments. Provides post audit findings and recommendations to ensure contractual State and Federal Compliance.
+ Coordinates development of written policies and procedures regarding compliance with local, state and federal guidelines.
+ Establishes member grievance appeals and policies and updates annually or as directed by the Centers for Medicare and Medicaid Services.
+ Establishes non-contracted provider dispute and appeals policies and policies and updates annually or as directed by the Center for Medicare and Medicaid.
+ Responsible for development, implementation, and maintenance of department strategic initiatives.
**JOB QUALIFICATIONS**
**Required Education**
Graduate Degree or equivalent combination of education and experience
**Required Experience**
7-9 years
**Preferred Experience**
10+ years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $88,453 - $172,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Actuary, Life Complex Reinsurance Administration & Monitoring

43201 Columbus, Ohio Lincoln Financial

Posted 7 days ago

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Job Description

**Alternate Locations:** Work from Home; Charlotte, NC (North Carolina); Fort Wayne, IN (Indiana); Greensboro, NC (North Carolina); Hartford, CT (Connecticut); Omaha, NE (Nebraska); Radnor, PA (Pennsylvania)
**Work Arrangement:**
Hybrid Preferred : Preferred employee will work 3 days a week in a Lincoln office
**Relocation assistance:** is not available for this opportunity.
**Requisition #:** 74633
**The Role at a Glance**
The Life Reinsurance team at Lincoln is responsible for coordinating reinsurance administration, execution, and monitoring efforts across Lincoln's Life Solutions organization. This expanding team is looking to onboard a data-driven actuary, accountant, accounting systems, or financial reporting expert to develop and maintain strategic reinsurance administration and monitoring processes. This person will play a leadership role in developing monitoring infrastructure on a backlog of transactions, and build infrastructure to administer new & existing life strategic reinsurance transactions. This person will work with deal leads to onboard new transactions into administration & monitoring systems and provide a key feedback loop to finance, reinsurance accounting, and deal leads on business performance and expectations of each transaction.
**What you'll be doing**
·Develops and maintains administration and monitoring infrastructure for strategic reinsurance transactions within the Individual Life line of business.
·Surveys upstream data providers and downstream data customers to develop understanding of how reinsurance data is used throughout Lincoln's information ecosystem.
·Leads development of data processes and reconciliation reports that are efficient, tractable, and instill confidence in the integrity of results for downstream stakeholders and auditors.
·Compiles historical information relating to deal implementation, intention, and performance expectations.
·Captures intentions and risks of strategic reinsurance transactions by understanding analysis performed at the time of deal inception and putting self in the shoes of the individuals/teams who executed the transaction.
·Leads actuaries to transform prior models or develop new models as needed to allow for side-by-side comparison of settlement line items, financial indicators, and deal performance drivers.
·Creates historical reviews on strategic reinsurance transactions, presenting findings to key stakeholders, and setting expectations of key drivers specific to subject transactions.
·Provides feedback to all parties involved in the reinsurance data ecosystem and uses expertise to recognize, probe, and remediate/explain when results are misaligned with expectation.
·Researches problems and questions from stakeholders across the organization, including but not limited to, Accounting, Finance, Life Solutions, M&A.
**What we're looking for**
-4 Year/Bachelor's degree or equivalent work experience (4 years of experience in lieu of Bachelor's) (Minimum Required)
-5-7+ Years experience in actuarial science, accounting, accounting systems, or financial reporting that directly aligns with the specific responsibilities for this position
-FSA, ASA with additional years of experience, CPA with additional years of experience, or advanced accounting degree with additional years of experience
-Proficiency and proven ability in model development, process development, or accounting system development.
-Ability to analyze complex information and to evaluate the implications of a course of action or solution.
-Ability to interpret and apply common sense understanding to carry out a variety of instructions furnished in written, oral, or diagram form.
-Ability to solve problems and deal with a variety of concrete variables in situations where only limited standardization exists.
-Define problems, collect data, establish facts and draw valid conclusions.
-Evaluate trends in data or information.
**Application Deadline**
Applications for this position will be accepted through August 31st, 2025 subject to earlier closure due to applicant volume.
**What's it like to work here?**
At Lincoln Financial, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.
**What's in it for you:**
+ Clearly defined career tracks and job levels, along with associated behaviors for each of Lincoln's core values and leadership attributes
+ Leadership development and virtual training opportunities
+ PTO/parental leave
+ Competitive 401K and employee benefits ( Free financial counseling, health coaching and employee assistance program
+ Tuition assistance program
+ Work arrangements that work for you
+ Effective productivity/technology tools and training
The pay range for this position is $93,300 - $169,700 with **anticipated pay for new hires between the minimum and midpoint of the range** and could vary above and below the listed range as permitted by applicable law. Pay is based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln's total rewards package for employees. In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual. Other rewards may include long-term incentives, sales incentives and Lincoln's standard benefits package.
**About The Company**
Lincoln Financial (NYSE: LNC) helps people to confidently plan for their version of a successful future. We focus on identifying a clear path to financial security, with products including annuities, life insurance, group protection, and retirement plan services.
With our 120-year track record of expertise and integrity, millions of customers trust our solutions and service to help put their goals in reach.
Lincoln Financial Distributors, a broker-dealer, is the wholesale distribution organization of Lincoln Financial. Lincoln Financial is the marketing name for Lincoln Financial Corporation and its affiliates including The Lincoln National Life Insurance Company, Fort Wayne, IN, and Lincoln Life & Annuity Company of New York, Syracuse, NY. Lincoln Financial affiliates, their distributors, and their respective employees, representatives and/or insurance agents do not provide tax, accounting or legal advice.
Lincoln is committed to creating a diverse and inclusive ( environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Follow us on Facebook ( , X ( , LinkedIn ( , Instagram ( , and YouTube ( . For the latest company news, visit our newsroom ( .
**Be Aware of Fraudulent Recruiting Activities**
If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.
Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln's fraud team at if you encounter a recruiter or see a job opportunity that seems suspicious.
**Additional Information**
This position may be subject to Lincoln's Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln's current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.
Any unsolicited resumes or candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial are considered property of Lincoln Financial and are not subject to payment of agency fees.
Lincoln Financial is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, Veteran status, or genetic information. Applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling .
This Employer Participates in E-Verify. See the E-Verify ( notices.
Este Empleador Participa en E-Verify. Ver el E-Verify ( avisos.
Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.
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