- 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
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… 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 ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… 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
- 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
- CVS Health (Atlanta, GA)
- …And we do it all with heart, each and every day. The Lead Director , National VBC Performance Planning & Insights will act as a strategic leader driving ... guide business decisions for national and local providers. The Director will also play a key role in supporting...efforts and adjusting strategies accordingly + Work closely with Medicare Quality team to ensure that reporting highlights areas… more
- Humana (Atlanta, GA)
- …join our team as the Head of Talent Acquisition, for our CenterWell Senior Primary Care Organization (PCO). The PCO, including CenterWell and Conviva, delivers care ... to approximately 300,000 patients from many different Medicare Advantage health plans, and is the largest provider...Advantage health plans, and is the largest provider of senior -focused primary care in the country. Across these two… 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
- Danaher Corporation (Atlanta, GA)
- …commercial customer engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value ... Danaher Business System (https://www.danaher.com/how-we-work/danaher-business-system) which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position is a… 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 (Marietta, 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
- CenterWell (Atlanta, GA)
- … medical expertise with the care team through daily huddles. . Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over 350 centers across… more
- CenterWell (Decatur, GA)
- … medical expertise with the care team through daily huddles. + Helps Area Medical Director and Center Administrator in setting a tone of cooperation in ... scope and complexity ranging from moderate to substantial. CenterWell Senior Primary Care is one of the largest and...protocol defined by Clinical Leadership. + Meets with Area Medical Director and Lead Cardiologist about quality… more