• Managed Care Leader

    WTW (Atlanta, GA)
    …Wealth and Career and Risk and Broking. The Managed Care Growth Leader is the primary client lead managing the totality of the Willis Towers Watson ... (WTW) relationship for clients within the Managed Care Industry. This individual is accountable...business while managing existing revenue and profit streams + Lead the development and execution of client account plans… more
    WTW (03/26/25)
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  • Medical Director - Care Plus - Florida

    Humana (Atlanta, GA)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (04/24/25)
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  • Manager, Post Acute Complex Care

    ChenMed (Decatur, GA)
    …cost, quality and value, and other clinical issues, especially within a managed care environment, required We're ChenMed and we're transforming healthcare ... quality improvement initiatives and special projects as assigned by leader and requested by ChenMed and/or Complex Care...and D and cost mitigation strategies + Understanding of Managed Medicare guiding principles + Ability to monitor, assess… more
    ChenMed (04/30/25)
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  • Patient Care Manager Senior

    Gentiva (Conyers, GA)
    …of terminally ill patients and their families. + Thorough knowledge of managed care principles, regulatory guidelines (ie, Medicare, Medicaid, JCAHO, ACHC, ... is a member of the Gentiva family - an industry leader in hospice, palliative, home health, and personal home care . Our place is by the side of those who need… more
    Gentiva (05/21/25)
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  • Pharma Field Sales - Diabetes Care

    Novo Nordisk (Decatur, GA)
    …in order to influence formulary status, as applicable + May analyze impact of managed care in the territory and its effect on prescribing decisions, and ... the people who need them most. At Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious chronic conditions such as… more
    Novo Nordisk (05/17/25)
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  • Lead , Medicaid Ins Product Strategy

    Humana (Atlanta, GA)
    … - Benefits is an experienced healthcare strategist that possesses broad Medicaid Managed Care expertise, deep working knowledge of insurance products, and has ... track record of bringing new benefits to market. The Lead will partner across various multi-disciplinary teams at Humana...on Medicaid populations + Deep working knowledge of Medicaid managed care policy, programs, and covered services… more
    Humana (05/16/25)
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  • Contracts Compliance Resolution Supervisor

    State of Georgia (Fulton County, GA)
    …seeking a qualified candidate for the Contracts Compliance Resolution Supervisor position in the Managed Care Services & Compliance Unit. The Managed Care ... (of which approximately 1.8 million are in the Medicaid managed care program (also known as Georgia...job-related experience which includes two (2) years in a lead worker, team leader , or supervisory role… more
    State of Georgia (05/19/25)
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  • VP, Revenue Cycle Management and Payer Strategy

    Cardinal Health (Atlanta, GA)
    leader responsible for leading all aspects of Navista's Physician Office's revenue cycle, managed care and value based care programs and services. Key ... developing team members, and innovation + Develops and implements managed care contracting strategy including implementation of...with the payer, provider, and service partners to enhance care delivery and provider support. + Lead more
    Cardinal Health (05/17/25)
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  • Medical Director - Medicaid N. Central

    Humana (Atlanta, GA)
    …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (05/14/25)
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  • Medical Director - Mid West Region

    Humana (Atlanta, GA)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (05/14/25)
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  • Clinical Pharmacist, Population Health - PGY1…

    ChenMed (Decatur, GA)
    …proactive professional who excels in evidence-based pharmacy practices. With a focus on managed care , this person will prioritize the most cost-effective options ... modified at manager's discretion. KNOWLEDGE, SKILLS AND ABILITIES: + Strong understanding of managed care practices and operations. + Knowledge of and experience… more
    ChenMed (03/11/25)
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  • AVP, Medicaid Proposal Strategy - Remote

    Molina Healthcare (Atlanta, GA)
    …and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 8+ years of Medicaid managed care experience or in an equivalent related field * Ability ... with Medicaid Proposals and/or business development and requires demonstrated Medicaid managed care experience comprised of technical operational, sales, growth,… more
    Molina Healthcare (04/30/25)
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  • Telephonic Nurse Case Manager Senior

    Elevance Health (Atlanta, GA)
    …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. Please be ... The **Telephonic Nurse Case Manager Senior** is responsible for care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (05/16/25)
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  • Telephonic Nurse Case Manager Senior

    Elevance Health (Atlanta, GA)
    …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. For candidates ... The **Telephonic Nurse Case Manager Senior** is responsible for care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (05/16/25)
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  • Medical Director (Medicare)

    Molina Healthcare (GA)
    …and evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PR** **E** **FE** **R** **RED L** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
    Molina Healthcare (05/02/25)
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  • Medical Director Specialty Medical Services…

    Molina Healthcare (Macon, GA)
    …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
    Molina Healthcare (04/09/25)
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  • Center Administrator

    CenterWell (Decatur, GA)
    …**Preferred Qualifications** + Basic knowledge of Population Health Strategy + Medicare knowledge + Managed care experience + Value Based Care knowledge + ... TB. + Direct leadership experience and demonstrated ability to lead , coach and mentor teams + Proven interpersonal skills...of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial… more
    CenterWell (03/04/25)
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  • Vice President, Business Development - Provider

    Evolent (Atlanta, GA)
    …and proficiency + Personally initiate and foster executive level relationships at managed care organizations and large provider groups + Collaborate with ... proven success with complex, multi-million-dollar enterprise sales + Knowledge of the managed care and provider markets (both payers and risk-bearing… more
    Evolent (05/20/25)
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  • National Account Director - Market Access

    IQVIA (Atlanta, GA)
    …and clients. RESPONSIBILITIES . Execute the effective launch of new drugs in Managed Care accounts, PBMs, Medicaid PBMs, and State Government Accounts by ... national and regional accounts, under the direction of the project's Client Lead . This includes developing contracts to optimize plan access, creating and following… more
    IQVIA (05/21/25)
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  • Clinical Sleep Specialist

    ZOLL Medical Corporation (Savannah, GA)
    …+ Experience working with VA hospitals and the VA System and or large managed care organizations (ie, Kaiser, WellStar) preferred. + Two years minimum of ... ability to multi-task and prioritize work. + Familiarity with clinical reimbursement, and managed care policies and procedures is highly desirable. + Above… more
    ZOLL Medical Corporation (05/20/25)
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