- Molina Healthcare (Columbus, GA)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Columbus, GA)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Columbus, GA)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (Columbus, GA)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Elevance Health (Columbus, GA)
- …on ethical and clinically appropriate use of healthcare data. + Partner with Provider Network leaders to shape modernization strategies that drive value-based ... **Manager, Medical Director - Transformation Initiatives** Location: This role requires...Payment Integrity** + **Care Management / Utilization Management (CM/UM) Modernization** + ** Provider Networking &… more
- Auburn University (Auburn, AL)
- …security, and scalability of all IT infrastructure, including disaster recovery, asset management , and network security. + Lead and coordinate major IT ... of IT infrastructure professionals, including managers and technical staff. + Provide personnel management , including supervision, work assignments, setting… more
- Molina Healthcare (Columbus, GA)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Columbus, GA)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Columbus, GA)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more
- State of Georgia (Muscogee County, GA)
- …and social service agencies | Monitors the quality and adequacy of the DD provider network in the region, identifies gaps, and works to expand choices ... for Statewide meetings Job Summary: Under broad supervision of the Director of Field Operations for Developmental Disabilities (DD), the DD RegionalServices… more
- Elevance Health (Columbus, GA)
- Medical Management Clinician Associate - 40 hours, 4-5 days/week, Saturdays and Sundays **Location:** This role enables associates to work virtually full-time, with ... may be 12 hrs, 10 hours, or 8 hours. The **Medical Management Clinician Associate** responsible for ensuring appropriate, consistent administration of plan benefits… more
- Molina Healthcare (Columbus, GA)
- …Processing, Provider Services, Provider Enrollment, Finance, Managed Care Provider Network ), for management and supervision of daily functional ... annual performance goals with assigned department managers, in conjunction with the Director , Account Management so that department goals support overall account… more
- Auburn University (Auburn, AL)
- …Number** Stu04799P **Home Org Name** Game Operations **Division Name** Director Intercollegiate Athletics **Position Title** Game Operations Student Worker **Working ... from Position Title)** **Job Summary** **Auburn Athletics Student Workers** assist event management in setup, game operations, and tear down of events during our… more
- Auburn University (Auburn, AL)
- …Number** Stu04727P **Home Org Name** Ath Equestrian **Division Name** Director Intercollegiate Athletics **Position Title** Student Worker - Equestrian Center ... and make informed decisions about your future career goals. + **Build your network !** Interacting with faculty, staff, and fellow students can lead to valuable… more