- Molina Healthcare (Macon, GA)
- …design solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience, Enrollment, and Claims ... **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a team designing...combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or… more
- Molina Healthcare (Macon, GA)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (Macon, GA)
- …optimization, and service delivery + Overseeing implementation of scalable solutions for provider onboarding, data management , and credentialing operations + ... **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new implementations… more
- Molina Healthcare (Macon, GA)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management /Network Adequacy. **Knowledge/Skills/Abilities** + ... work with other teams including New Markets team, Network Management , Product Teams, PDM and IT. **Job Qualifications** **REQUIRED...EXPERIENCE:** + Advanced Excel skills. + Power BI. + Provider Data Analytics. To all current Molina… more
- Molina Healthcare (Macon, GA)
- …regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization Management ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Macon, GA)
- …of value-based care models, provider enablement strategies, and population health management . + Strong knowledge of data integration, EMR systems, and ... programs focused on provider enablement, ensuring access to tools, training, and data for success in VBC models. + Design and implement VBC training programs,… more
- Molina Healthcare (Macon, GA)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Assists in recruitment, hiring and training of staff as needed. + Analyzes data and identifies medical cost savings and quality improvement opportunities. + Accounts… more
- Molina Healthcare (Macon, GA)
- …* Provides direct oversight, monitoring and training of local plans' provider dispute and appeals units to ensure adherence with Medicare standards ... and requirements related to non-contracted provider dispute/appeals processing. * Establishes member and non-contracted provider grievance/dispute and appeals… more
- Molina Healthcare (Macon, GA)
- …compliance program, including annual, periodic, focal, etc. audits. * Performance Management & KPI Expertise: Develop, implement, and monitor KPIs, including leading ... adherence, diagnose root causes of misses, and drive accountability across functions. * Data Insight & Decision Support: Ingest and interpret complex data from… more
- Grifols Shared Services North America, Inc (Macon, GA)
- …solutions and services in more than 110 countries and regions. The Director , Pricing & Access Analytics is responsible for developing and applying advanced ... + Track win/loss trends to refine pricing and contracting strategies. Provide insights into pricing and contracting performance and recommend adjustments based… more
- Molina Healthcare (Macon, GA)
- …development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and supports (LTSS), ... establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Responsible… more
- Air National Guard Units (Robins AFB, GA)
- …Officers and Weapons Directors to perform weapons control and battle management functional duties. Provide recommendations on training requirements, performance ... you will: Perform as an instructor for the Air Battle Manager/Weapons Director position. Ensure training encompasses the full spectrum of theory, formal classroom… more
- ZOLL Medical Corporation (Macon, GA)
- …we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our ... patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed… more
- Guidehouse (Robins Air Force Base, GA)
- …**What You Will Do** **:** The Senior Acquisition Program Manager will provide comprehensive support across the Department of Defense (DoD) acquisition lifecycle, ... internal and external stakeholders, supporting capability planning, and applying program management best practices. The candidate will also assist in integrated… more
- Air National Guard Units (Robins AFB, GA)
- …instruction for the following positions: Procedural Controller rated Weapons Director (WD) and Interface Control Technician (ICT). Administers, schedules, and ... of assigned personnel. This position requires paramount knowledge of Air Battle Management techniques and procedures and must possess and maintain the appropriate PC… more
- Northrop Grumman (Warner Robins, GA)
- …invoicing, collections, and funding to support financial objectives. + Enter and manage data in the Contract Management System, financial and delivery systems. + ... support various Government programs, capture and proposal activities as well as provide contract operations support. The successful candidate will be a direct report… more
- Northrop Grumman (Warner Robins, GA)
- …Goals, Objectives, and Outcomes for the program. _ _ _Goals - Provide transitioning service members fellowship-style job skills training during the last_ _portion_ ... with providing the skills and experience required to support a robust Quality Management System designed to ensure products and services meet or exceed internal and… more