• Director , Operational

    Molina Healthcare (Atlanta, GA)
    …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve. ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
    Molina Healthcare (10/09/25)
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  • Senior Analyst, Operational Regulatory…

    Molina Healthcare (Atlanta, GA)
    …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
    Molina Healthcare (08/22/25)
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  • Medicare Segment Optimization…

    Molina Healthcare (Atlanta, GA)
    …**Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function ... as Medicare subject matter expert and point of contact for...drive compliance and performance objectives as well as provide oversight , including service level agreements. + Works with staff… more
    Molina Healthcare (09/07/25)
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  • Lead Director , Project Program Management,…

    CVS Health (Atlanta, GA)
    …heart, each and every day. **Position Summary** Drive growth for Medicare Advantage External Distribution Partnerships by setting strategic sales goals, crafting ... achieve measurable results. Act as Chief of Staff to the Executive Director of National External Distribution, ensuring alignment and execution of strategic… more
    CVS Health (10/04/25)
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  • Director , Provider Network Management…

    Molina Healthcare (Atlanta, GA)
    …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
    Molina Healthcare (08/20/25)
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  • National Medical Director , Home-Based Care…

    CenterWell (Atlanta, GA)
    …improvement. + Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities. **Quality Improvement ... and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical...skills; ability to collaborate effectively with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare more
    CenterWell (10/02/25)
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  • Director I - Graduate Medical Education

    Morehouse School Of Medicine (Atlanta, GA)
    Director I - Graduate Medical Education Bookmark this Posting Print Preview | Apply for this Job Please see Special Instructions for more details. Employment in this ... career at MSM ! Posting Number NONAC3601 Job Title Director I - Graduate Medical Education Position Title ...high level of expertise and understanding of the Federal Medicare GME financing, CMS regulations, and ACGME program requirements.… more
    Morehouse School Of Medicine (08/08/25)
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  • Clinical Account Director - Remote

    Prime Therapeutics (Atlanta, GA)
    …passion and drives every decision we make. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director is ... As the primary point of contact for their designated BCBS clients, the director promotes and recommends Prime standard offerings to meet client requirements and… more
    Prime Therapeutics (10/01/25)
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  • Director , Appeals & Grievances (Remote)

    Molina Healthcare (Atlanta, GA)
    …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
    Molina Healthcare (09/26/25)
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  • Director , Internal Audit

    Waystar (Atlanta, GA)
    **ABOUT THIS POSITION** The Internal Audit Director is a critical leadership role responsible for developing, implementing, and overseeing the internal audit ... across the organization. The position will be focused on oversight of the entire SOX compliance program (including both...and ITGCs) and may expand to cover risk based operational audits in the future. The ideal candidate should… more
    Waystar (09/19/25)
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  • Director , Denial Resource Center

    Baylor Scott & White Health (Atlanta, GA)
    …, Denial Resource Center is responsible for the strategic planning, evaluation, and operational oversight of the clinical denial management function for Baylor ... Scott and White Health (BSWH). The Director , Denial Resource Center will lead a highly skilled...function for BSWH. + Recommends and implements strategic and operational plans and priorities for clinical denial management aligned… more
    Baylor Scott & White Health (10/04/25)
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  • Director , Clinical and Revenue Integrity…

    Waystar (Atlanta, GA)
    **ABOUT THIS POSITION** The Director , Clinical and Revenue Integrity Operations is responsible for the oversight and management of our team of Revenue Integrity ... to be an integral part of ongoing product and operational strategy. Technical and process aptitude is a must....systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
    Waystar (09/25/25)
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  • AVP, Encounters

    Molina Healthcare (Atlanta, GA)
    …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more
    Molina Healthcare (08/22/25)
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  • Facility Caretaker (PRN) Day - Adult CSU…

    State of Georgia (Gwinnett County, GA)
    …the Director . Manages the planning, development, and implementation of operational support services for a facility. Develops and implements policies and ... disabilities. View Point Health serves uninsured, underinsured, low-income Medicaid, Medicare , war veterans and some private insurance across multiple locations… more
    State of Georgia (10/03/25)
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