- Molina Healthcare (Atlanta, GA)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- 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 ... winning strategies, and optimizing performance. Partner with senior leaders to deliver innovative solutions, streamline processes, and achieve measurable results.… more
- Humana (Decatur, GA)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live… more
- CenterWell (Atlanta, GA)
- …and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy ... community and help us put health first** The National Medical Director for Home-Based Care Programs is...medical direction, clinical oversight, and advancement of CenterWell Senior Primary Care's (and Conviva Senior Primary… more
- Evolent (Atlanta, GA)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications -...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Atlanta, GA)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** +...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Atlanta, GA)
- …MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Atlanta, GA)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Humana (Atlanta, GA)
- …part of our caring community and help us put health first** The Director , Internal Audit develops, plans and evaluates internal audit programs for the organization's ... ensure compliance with the organization's policies, procedures and standards. The Director , Internal Audit requires an in-depth understanding of how organization… more
- Danaher Corporation (Atlanta, GA)
- …to effectively coordinate and engage targeted customers within the US. Reporting to the Senior Director of Market Access Americas, this highly visible role will ... the Danaher Business System which makes everything possible. The Field Reimbursement Director position is a provider / customer facing role responsible for… more
- Humana (Atlanta, GA)
- …those customers at the center of everything it does. The MarketPoint Director , Channel Development defines the cross-channel implementation plan to support the sales ... leading national and regional sales growth and retention initiatives. The Director , Channel Development requires a comprehensive understanding of how MarketPoint… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Internal Audit Director is a critical leadership role responsible for developing, implementing, and overseeing the internal audit ... delivery of high-quality audit results across the company. The Director will work closely with executive leadership and the...and present audit findings, recommendations, and action plans to senior management and the Audit Committee. + Monitor and… more
- Baylor Scott & White Health (Atlanta, GA)
- … senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key ... **Job Summary** The Director , Denial Resource Center is responsible for the...improved utilization of appropriate patient care services. Collaborates with medical , clinical, HIM and other BSWH departments to ensure… more
- CenterWell (Atlanta, GA)
- …, Informatics** will be responsible for supporting Patient Safety analytics on the Medicare population. The Associate Director is expected to perform and present ... of our caring community and help us put health first** The Associate Director , Informatics coordinates with other analytics, IT and business areas across the… more
- WelbeHealth (Atlanta, GA)
- …senior care by providing an all-inclusive care option to our most vulnerable senior population. The Director , Federal Government Affairs will lead a bold ... regulatory affairs function with Congress and the Centers for Medicare and Medicaid Services (CMS) + Develop and implement...uniquely cared for. + 401k + employer match + Medical insurance coverage ( Medical , Dental, Vision) starting… more
- Molina Healthcare (Atlanta, GA)
- …activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Gentiva (Stockbridge, GA)
- …functions, including documenting referrals, new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining ... ON BONUS We're looking for a **Patient Care Manager Senior ** to join our team. You will report directly...our team. You will report directly to the Executive Director or Administrator. You will be responsible for assisting… more
- ChenMed (Atlanta, GA)
- …1-2 days out of each week out of your home base market. The Senior Manager, Referrals is responsible for providing support to ChenMed, et. al regarding internal ... and creating trainings to guide the Chenmed company's on referral processes. The Senior Manager, Referrals is the subject matter expert in Referrals processes for… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Medicine. The clinical performance will be evaluated by the Emergency Department Medical Director /Service Chief of the fellow's base hospital and reviewed ... Health System. Fellows must be eligible at participants in Medicare , Medicaid and other third-party payers contracted with Emory...programs affiliated hospitals under the direction of the ED director of that hospital + May supervise medical… more
- CenterWell (Atlanta, GA)
- …participant and lead with the care team through daily huddles. . Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of ... one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over...to write prescriptions under the authority of a collaborating physician/ medical director + This role is considered… more