- 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
- 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
- Elevance Health (Atlanta, GA)
- …+ Certification as a Case Manager is preferred. + Participation in the American Association of Managed Care Nurses is preferred. + Prior managed care ... to interpret and apply member contracts, member benefits, and managed care products is strongly preferred. Please...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- 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
- 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
- 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 (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 (Atlanta, GA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
- Zurich NA (Atlanta, GA)
- …profitability goals and ensure the delivery of quality, cost effective services to our Managed Care stakeholders. You will act as a subject matter expert and ... the AVP of Utilization Review & Pharmacy, you will lead and direct a team of Utilization Review and...technical resource to Managed Care stakeholders regarding operational and regulatory… more
- 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
- Elevance Health (Atlanta, GA)
- …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. For candidates ... **Telephonic Nurse Case Manager II** is responsible for performing 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
- Molina Healthcare (Atlanta, 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 (Atlanta, 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
- 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
- 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
- WTW (Atlanta, GA)
- …including producers, client advocates, broking teams, and sub-segment leaders (Life Sciences, Managed Care & Senior Living) + Actively participate on both ... Role** The Healthcare and Life Sciences (HC&LS) Industry Vertical leader is highly-collaborative and provides both the strategic vision...evolve the business, + Participate in sales calls and lead the delivery of the value propositions, + Educate… more
- Grifols Shared Services North America, Inc (Atlanta, GA)
- …connect them with the customer as appropriate + Possess an understanding of the Managed Care landscape and when to utilize necessary internal resources to assist ... and functions including Territory Sales Representatives, Regional Sales Directors, Managed Markets, the Product Brand Team and other necessary stakeholders.… more
- Elevance Health (Atlanta, GA)
- …the healthcare industry is preferred. + Actuarial experience within a healthcare and/or managed care organization preferred + Some exposure to healthcare or ... health programs and strong understanding of actuarial principles and managed care operations preferred. + Possess working...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Molina Healthcare (Atlanta, GA)
- …or equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or ... level (or higher) **Preferred Education** Bachelor's Degree **Preferred Experience** + 5+ years managed care experience + QNXT + Crystal Reports for data… more
- Molina Healthcare (Atlanta, GA)
- …* 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/ Managed Care experience * Experience demonstrating strong management and ... dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more