- Elevance Health (Columbus, GA)
- ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the...creating a culture that is designed to advance our strategy but will also lead to personal and professional… more
- Highmark Health (Atlanta, GA)
- …Highmark Inc. **Job Description :** **JOB SUMMARY** As part of the enterprise strategy to integrate and scale pharmacy solutions that disrupt the pharmacy supply ... responsible for the execution and value realization related to strategy development, operational excellence, pricing optimization, vendor coordination, and assisting… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- NASCO (Atlanta, GA)
- …parent's Enterprise Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship ... **Overview** As Executive Director , Compliance you will lead and provide oversight...Medicare Advantage and Exchange customers, including contract management, strategy development, operational delivery and invoicing + Engages with… more
- Humana (Atlanta, GA)
- …our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates ... Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** The National Program Director - Value-Based Care is a strategic leadership role responsible for the development, implementation, ... evolution of value-based care (VBC) programs across all lines of business-Medicaid, Medicare , and Marketplace. This role is critical in driving clinical and… more
- Humana (Atlanta, GA)
- …of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy , and identifying improvement opportunities for a ... projects from concept to execution **Additional Information** This role reports to the Director of Strategy , works collaboratively with members of rest of the… more
- CenterWell (Atlanta, GA)
- …are followed, and fosters collaboration across entities within the Primary Care Organization. ** Strategy :** + In partnership with AVP, Risk Adjustment and AVP, MRA ... Strategy , responsible for driving ongoing efficiency and effectiveness of...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Creative Director , Brand Marketing, will play an integral role in shaping and executing Waystar's brand vision. Reporting to the SVP, ... details to deliver impactful results. **WHAT YOU'LL DO** **Brand Strategy & Leadership** + Shape and advance Waystar's...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Prime Therapeutics (Atlanta, GA)
- …and drives every decision we make. **Job Posting Title** Trade Client Relations Director - Remote **Job Description** The Trade Client Relations Director is ... related product development and implementation + Lead and coordinate work for Prime's Medicare Center of Excellence, maintaining an in depth understanding of work in… more
- Evolent (Atlanta, GA)
- …as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to solve ... teams of actuaries and non-actuaries, including support for team engagement and strategy + Present reports and analyses to clients and internal executives… more
- Molina Healthcare (Savannah, GA)
- …* Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). ... and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates.… more
- Cognizant (Atlanta, GA)
- …health plan payers, by demonstrating deep expertise in Government healthcare ( Medicare ). The Elements Product Consultant works directly with customers to understand ... Product Managers across the product portfolio to operationalize the strategy based on market trends and solution offerings. ....solution offerings. . Work hand in hand with the Director of Elements HPC and other areas of the… more
- Waystar (Atlanta, GA)
- …to highly useable software. This professional self-starter will report to a Director , Product Management and work closely with User Experience team and Technology ... Product Management to manage the product roadmap, including documenting product strategy , maintaining the feature backlog, and coordinating releases + Organizing… more
- Humana (Atlanta, GA)
- …in DevOps practices. You will be responsible for driving the vision and strategy for our DevOps platform(s), ensuring that our software engineers can deliver ... Work Arrangements Available **Reporting Information** + You will report to the Director of Enterprise DevOps and Enterprise Engineering Enablement. + You will be… more
- Molina Healthcare (GA)
- …Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational ... Tighter knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates Complex Provider contracts including but not… more
- Waystar (Atlanta, GA)
- …performance and pipeline for the organization. You will report directly to the Director of Digital Marketing and work with an expanding marketing operations team to ... at the right time + Support Waystar's account-based marketing strategy and ABM campaign initiatives + Manage the relationship...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more