• Medicaid Senior Researcher (Senior…

    Abt Global Inc. (Atlanta, GA)
    …Capability team, you will lead work in the health care portfolio, including business development efforts. The successful candidate will have extensive experience ... in Medicaid program operations , data, and policies. You...subject matter expertise to support health care projects and business development efforts. + Lead the technical… more
    Abt Global Inc. (04/05/24)
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  • Medicaid (PPS) Provider Hospital…

    Humana (Atlanta, GA)
    …will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new states. The business more
    Humana (04/24/24)
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  • Investigator - Medicaid Fraud Division

    State of Georgia (Fulton County, GA)
    Investigator - Medicaid Fraud Division Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/37043/other-jobs-matching/location-only) Hot ... into the Executive Office, five legal divisions, four specialty units and an operations division. The position filled through this announcement will serve in the… more
    State of Georgia (04/17/24)
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  • Manager Data Analysis & Testing - Medicaid

    Highmark Health (Atlanta, GA)
    …on cross-functional efforts, in this role the incumbent should also act as a business data subject matter expert hands on where possible, and guide, lead and educate ... to: involved in hiring and termination decisions, coaching and development , rewards and recognition, performance management and staff productivity.Plan, organize,… more
    Highmark Health (04/17/24)
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  • RVP of Business Development - South…

    Aveanna (Atlanta, GA)
    RVP of Business Development - South Central (Hybrid) ApplyRefer a FriendBack Job Details Requisition #: 195373 Location: Atlanta, GA 30339 Category: Sales ... - $185,000 per year Position Details Position Overview The Regional Vice President, Business Development is instrumental in driving revenue growth and admissions… more
    Aveanna (04/17/24)
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  • Business Consultant

    HealthEdge Software Inc (Atlanta, GA)
    …issues and client impacts. + Partner withappropriate Source Teams(BA, PM, Development , Account Management, Sales/ Business Development , Product, Content, ... Medicaid , and commercial), payment integrity, and healthcare plan operations (eg, claim life cycle/workflow, network contracting, payment/policy configuration,… more
    HealthEdge Software Inc (05/04/24)
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  • Value-Based Programs Lead

    Humana (Atlanta, GA)
    …to value. + Align scope of work with roadmap for new VBP model development to ensure compliance with Medicaid contractual requirements and RFP commitments. + ... financial terms, which align with segment goals. + Design and contribute to development of provider reporting packages to help providers understand their overall and… more
    Humana (05/03/24)
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  • HCBS Consultant/Sr. HCBS Consultant

    Mathematica (Atlanta, GA)
    …and family support to nutrition, employment, disability, and international development . Mathematica offers our employees competitive salaries, and a comprehensive ... improving state Home- and community-based services within the state's Medicaid or HCBS administrative agencies such as health, human...consulting services to state and local clients, support the development of new health policies, assist with the … more
    Mathematica (05/03/24)
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  • Associate Director, Business Intelligence

    Humana (Atlanta, GA)
    …priorities on a regular basis. + Embrace a service mentality to collaborate with Operations , Business Intelligence teams, Database teams, and IT to assure data ... our caring community and help us put health first** The Associate Director, Business Intelligence for CPSS Data and Analytics will support the account services,… more
    Humana (05/02/24)
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  • Director, Clinical Account Services - Remote…

    Prime Therapeutics (Atlanta, GA)
    …overall administration of the programs. Activities address impact on customers, operations , program integrity, pricing, quality and satisfaction. Develops and tracks ... expertise with data management and overall healthcare trends specific to the Medicaid population. **Job Description** + Partners with appropriate staff in the… more
    Prime Therapeutics (04/04/24)
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  • Principal Researcher/Senior Fellow - Public Health…

    Mathematica (Atlanta, GA)
    …to the collection and interpretation of quantitative and qualitative data * Direct business development efforts and lead proposals for new projects * Author ... and family support to nutrition, employment, disability, and international development . Mathematica offers our employees competitive salaries, and a comprehensive… more
    Mathematica (05/04/24)
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  • Sr. Value-Based Programs Professional (Remote US)

    Humana (Atlanta, GA)
    …will be responsible for leading the beginning-to-end operational support of specialty Medicaid value based payment (VBP) models in alignment with segment strategy ... + Analyze utilization data to reconcile provider disputes + Contribute to development and support of provider reporting packages to help providers understand their… more
    Humana (04/24/24)
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  • Behavioral Health Consultant/Sr. Behavioral Health…

    Mathematica (Atlanta, GA)
    …and family support to nutrition, employment, disability, and international development . Mathematica offers our employees competitive salaries, and a comprehensive ... improving state behavioral health programs within or in conjunction with Medicaid programs and state, local, and private providers. Experience managing public… more
    Mathematica (05/03/24)
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  • Director, Compliance Investigations - Remote…

    Option Care Health (Atlanta, GA)
    …action policies and procedures. Reporting to the VP, Compliance & Privacy Operations , this individual will also assist Compliance leadership with: * Developing and ... and adhere to legal and regulatory requirements, the Company's Code of Business Conduct and Company policies and procedures. * Assessing the effectiveness of… more
    Option Care Health (05/03/24)
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  • Senior Enterprise Architecture - EA Activation

    Humana (Atlanta, GA)
    …+ 2+ years of project leadership and consulting experience. + Health Care Business Domains - Medicare, Medicaid , Group, Specialty etc. **Additional Information** ... help us put health first** Are you interested in leveraging technology and business strategy to deliver improved member experiences and health outcomes to Humana's… more
    Humana (04/30/24)
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  • Senior Learning Design Professional

    Humana (Atlanta, GA)
    …**Preferred Qualifications** + Medicaid knowledge, including experience with interpreting Medicaid contracts. + Operations content design and facilitation + ... work experience. + 3+ years of instructional design, training and learning development experience + Expert level experience with the Articulate 360 suite +… more
    Humana (05/03/24)
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  • Product Manager

    Waystar (Atlanta, GA)
    …The Product Manager will coordinate with key stakeholders in sales, marketing, design, development , and operations . This role will be charged with leading game ... various product inputs, customer requirements, designing solution architectures and developing the business case for new product development + Preparing software… more
    Waystar (04/03/24)
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  • Staff VP CareMore STARS

    Elevance Health (Atlanta, GA)
    …VP CareMore Stars acts as the driving force behind the development , coordination, communication, and strategic execution of top-tier clinical quality management ... programs for multi-state Medicare and Medicaid markets within Carelon Health. As a pivotal role within our organization, you'll have the chance to spearhead… more
    Elevance Health (05/02/24)
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  • Associate Director - Network Adequacy

    Humana (Atlanta, GA)
    …+ Advanced certifications in software and/or process improvement + Experience with Medicaid + Experience in provider networks/provider operations + Advanced ... Adequacy tests the overall network in each county of operations to ensure the network is strong enough to...matching program + Network Resource Groups (NRGs) + Career development opportunities **Use your skills to make an impact**… more
    Humana (04/24/24)
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  • Pharmacy Technician

    BrightSpring Health Services (Smyrna, GA)
    …technician, data entry , billing and IV technician functions to support clinical and business operations for the assigned region . Responsible for coordinating , ... med. or der system + Perform s computer system operations which may include order entry, billing, crediting, and...follow-up of claims , by maintaining current knowledge of Medicaid claim regulations and processes + Participates in orientation,… more
    BrightSpring Health Services (04/03/24)
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