- 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
- 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 ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Atlanta, GA)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... with cross-functional teams, including **clinical reviewers, product, management, and senior leadership,** to improve decision-making and care outcomes. + Assist… more
- Elevance Health (Atlanta, GA)
- …budgeting, and implementing initiatives that enhance operational efficiency across Commercial, Medicare , and Medicaid markets. The Director plays a critical ... **Strategy & Program Development Director - Payment Integrity Strategy & Planning** **Location:**...make an impact:** + Monitor related legislation and advise senior management on compliance. + Research new ventures and… more
- Prime Therapeutics (Atlanta, GA)
- …we make. **Job Posting Title** Sr Director Analytics **Job Description** The Senior Director Analytics is responsible for the development and execution of ... pharmacy benefit management (PBM) and Healthcare industry expertise to provide senior level strategic analytical consultative services to a variety of audiences… more
- CenterWell (Atlanta, GA)
- …MSSP, and future models. Under general direction and supervision from the ACO Director , the Senior Strategy Advancement Professional will bring a combination of ... an in-depth understanding of the healthcare industry, including value-based care, Medicare , population health, Accountable Care Organizations (ACOs), medical … more
- CenterWell (Atlanta, GA)
- …Leaders to identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying business partner ... of management experience + 8 or more years of Medical Coding, IPA, or similar experience + Medical...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
- Gentiva (Stockbridge, GA)
- …functions, including documenting referrals, new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining ... day. **Overview** We're looking for a **Patient Care Manager Senior ** to join our team. You will report directly...our team. You will report directly to the Executive Director or Administrator. You will be responsible for assisting… more
- Highmark Health (Atlanta, GA)
- …overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures ... drug benefit strategies, drug formularies, and programs specifically for the Medicare Advantage (MA) market. The incumbent will contribute to recommendations for… 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 (Decatur, 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 (Stone Mountain, 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 250 centers across… more
- CenterWell (Norcross, GA)
- …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...the care team through daily huddles. + Helps RegionalMedical Director and Center Administrator in setting a tone of… more
- CenterWell (Atlanta, GA)
- …. Appropriate certification to write prescriptions under the authority of a collaborating physician/ medical director . This role is considered patient facing and ... for TB. **Preferred Qualifications:** . Active and unrestricted DEA license . Medicare Provider Number/ Medicaid Provider Number . Experience managing Medicare … more
- CenterWell (Duluth, GA)
- …caring community and help us put health first** Reports To: Associate Director , Home Health Branch Administrator FLSA: Exempt **Work Schedule** : Full-time/40 Hours ... final audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers… more
- CenterWell (Atlanta, GA)
- …and pre-authorization/eligibility for the assigned area. + May oversee backfill for Branch Director and fill-in when Branch Director role may be open. **Use ... is required. + Minimum of 3 years of experience in a home health Branch Director role is required. + Management and people leadership experience is required. + OASIS… more
- City of Alpharetta, Georgia (Alpharetta, GA)
- …(age 55+ and 10+ yrs. of service) may continue individual coverage up until Medicare eligibility at age 65. Medical Reimbursement: retirees (age 55+ and 15+ ... Starting salary $81,350 to $91,350. Under administrative direction of the Director of Economic Development, performs a variety of professional-level duties in… more