Top 75 Manager i, mainframe engineering Jobs in Columbus, Oh

Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
8d
Behavioral Healthcare Provider Supervisor 1 (Correctional Reception Center) - PN 20021909
State of Ohio - Behavioral Health —Orient, OH
- $36.75 an hour
- Online Application
- Background check
- Nursing
- Psychiatry
- Paid holidays
- Health insurance
9d
Performance Improvement Manager (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Analysis skills
- Driver's License
- Team management
- Paid holidays
- Health insurance
8d
Transportation Manager I
DHL —Westerville, OH
- $85,000 - $110,000 a year
- Full-time
- 3 years
- Business development
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
Inventory Control Manager I
DHL —Lockbourne, OH
- $85,000 - $150,000 a year
- Full-time
- 3 years
- Bachelor's degree
- Experience equivalent to degree accepted
- Health insurance
- Dental insurance
Quick Apply
3d
Assistant Project Manager I
Quanta Infrastructure Solutions Group, LLC —Columbus, OH
- Full-time
- Mid-level
- Travel
- Contracts
- Paid holidays
- Health insurance
Business Applications Manager (Information Technology Manager 1) - 20035255
State of Ohio - Behavioral Health —Columbus, OH
- $48.93 an hour
- Overtime
- Background check
- Microsoft Access
- Computer Science
- Paid holidays
- Health insurance
1d
Managed Care Contract Manager (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Mid-level
- Office
- Analysis skills
- Paid holidays
- Health insurance
7d
IT SharePoint Manager (Information Technology Manager 1)
State of Ohio - Medicaid —Columbus, OH
- $48.93 - $69.94 an hour
- Overtime
- Computer Science
- Public speaking
- System design
- Paid holidays
- Health insurance
7d
Health Innovation Research Manager (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Mid-level
- Office
- Analysis skills
- Paid holidays
- Health insurance
10d
Senior Security Engineer
Medical Mutual of Ohio —Dublin, OH
- Hybrid work
- 7 years
- Office
- Bachelor's degree
- Health savings account
- Disability insurance
Office Manager I
Dermatologists of Central States —Canal Winchester, OH
- HIPAA
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
General Manager I - Distribution
DHL —Westerville, OH
- $120,000 - $155,000 a year
- Full-time
- Bachelor's degree
- Travel
- Warehouse
- Health insurance
- Dental insurance
Quick Apply
General Manager I
NFI Industries —Groveport, OH
- Extended hours
- Spanish
- 7 years
- Ability to walk for extended periods
Quick Apply
Sales Leader I - Healthcare Business Banking
PNC Financial Services Group —Columbus, OH
- $100,100 - $185,900 a year
- Full-time
- 5 years
- Mid-level
- Master's degree
- Wellness program
- Health savings account
Senior Operations Manager (Operations Manager I)
DHL —Lockbourne, OH
- $85,000 - $110,000 a year
- Full-time
- Project management
- Bachelor's degree
- Warehouse
- Health insurance
- Dental insurance
Quick Apply
8d
Assembler and COBOL - CICS Developer
Inabia Software & Consulting Inc. —Columbus, OH
- Mid-level
- Office
Sr. Project Manager I
HGC CONSTRUCTION CO. —Columbus, OH
- Full-time
- Construction site
- 5 years
- Senior level
Quick Apply
Data Center Security Installation Project Manager (Project Leader 1) - Columbus, Ohio
M.C. Dean, Inc —Columbus, OH
- $112,560 - $154,770 a year
- Full-time
- 7 years
- Computer Science
- Bachelor of Science
- Paid parental leave
- Disability insurance
OhioRISE CME Care Coordinator Supervisor I
THE VILLAGE NETWORK —Columbus, OH
- Full-time
- Experience working with individuals with developmental disabilities
- Computer literacy
- HIPAA
- Paid holidays
- Paid time off

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Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)

State of Ohio - Medicaid -
Columbus, OH

Apply Now

Job Details

Full-time
$40.40 an hour
8 days ago

Benefits

Paid holidays
Health insurance
Dental insurance
Paid time off
Vision insurance
Loan forgiveness
Life insurance

Qualifications

RN License
Customer inquiry handling

Full Job Description

What You Will Do At ODM:

Office: Legal Counsel

Bureau: Program Integrity

Classification: Medicaid Health Systems Administrator 1 RN (PN: 20092018)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). SURS is charged with helping the agency review utilization of Medicaid services, detect fraud, waste and abuse and recover inappropriate payments to providers. As a Clinical Review Nurse Supervisor your responsibilities will include:

Helping to manage an over $ 7million/ year hospital utilization contract
Reviewing necessary medical record reviews and making a determination on hospital appeals.
Supervising and training RNs, Auditors, and Analysts in identifying fraud, waste, and abuse in the Medicaid program.
Participating/leading meetings with external stakeholders including law enforcement
Developing and implementing changes to processes and procedures as needed in a team environment
Evaluating provider clinical compliance with state and federal Program Integrity rules
Evaluating provider medical documentation and billing practices for fraud, waste and abuse
Recovering overpayments for medically unnecessary services via administrative procedures and/or referrals to health oversight agencies
Responding to provider clinical reconsideration (appeal) requests
Consulting on clinical matters with ODM policy units and other state agencies
Coordinating clinical Program Integrity efforts with ODM contractors and managed care plans
Presenting findings from clinical reviews of provider non-compliance
Responding to inquiries from the public, consumers, providers, and other agencies

Why Work for the State of Ohio

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:

Medical Coverage
Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
Childbirth, Adoption, and Foster Care leave
Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation)

Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.

Qualifications

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis); Current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code;

Or 12 months experience as Medicaid Health Systems Specialist, 65293, may be substituted for the experience required, but not for the mandated licensure.

Note: education & experience is to be commensurate with approved position description on file.

Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure.

Technical Skills: Nursing

Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication

Supplemental Information

Supplemental Information:

Compensation is as listed on the posting unless required by legislation or union contract.

Must poses Current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code

This positions is overtime exempt.

Travel required, as needed. Must provide own transportation. Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence.

Resumes and/or attachments are not reviewed. Therefore, please provide detail in the work experience section of your application.

ADA Statement

Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.

Drug-Free Workplace

The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

Apply Now

Refine Your Search

manager i, mainframe engineering jobs in columbus, oh

Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)

Behavioral Healthcare Provider Supervisor 1 (Correctional Reception Center) - PN 20021909

Performance Improvement Manager (Medicaid Health Systems Administrator 1)

Transportation Manager I

Inventory Control Manager I

Assistant Project Manager I

Business Applications Manager (Information Technology Manager 1) - 20035255

Managed Care Contract Manager (Medicaid Health Systems Administrator 1)

IT SharePoint Manager (Information Technology Manager 1)

Health Innovation Research Manager (Medicaid Health Systems Administrator 1)

Senior Security Engineer

Office Manager I

General Manager I - Distribution

General Manager I

Sales Leader I - Healthcare Business Banking

Senior Operations Manager (Operations Manager I)

Assembler and COBOL - CICS Developer

Sr. Project Manager I

Data Center Security Installation Project Manager (Project Leader 1) - Columbus, Ohio

OhioRISE CME Care Coordinator Supervisor I

I want to receive the latest job alert for manager i, mainframe engineering in columbus, oh

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