- 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
- CVS Health (Atlanta, GA)
- …a willingness to learn about care management within Medicare and Medicaid managed care . + Familiarity with community resources and services. + Navigate ... each and every day. **Program Summary** Join our Aetna care management team as we lead the...Qualifications** + Case management and discharge planning experience + Managed care experience **Education** + High School… more
- Elevance Health (Atlanta, GA)
- …or related field; minimum of 5 years of experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Provider Contract/Cost of Care Consultant** **Location:** This role requires associates to...Works on complex enterprise-wide initiatives and acts as project lead . **How you will make an impact:** + Uses… 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
- Humana (Atlanta, GA)
- …and populations served in target growth markets. Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions ... us put health first** The Market Entry Capture Strategy Lead will lead initiatives to develop and...+ 5+ years' experience in a Medicaid or Medicare Managed Care Organization + 5+ years' experience… 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
- ChenMed (Decatur, GA)
- …proactive professional who excels in evidence-based pharmacy practices. With a focus on managed care , this person will prioritize the most cost-effective options ... modified at manager's discretion. KNOWLEDGE, SKILLS AND ABILITIES: + Strong understanding of managed care practices and operations. + Knowledge of and experience… 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 at the Inpatient… 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
- State of Georgia (Fulton County, GA)
- …currently seeking qualified applicants for a Compliance Specialist 3 - position with the Managed Care Services & Compliance Unit within the Service Delivery & ... of almost 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit...may plan, organize, or coordinate activities of the MAP Managed Care contracts and compliance unit. Tracks,… more
- Elevance Health (Atlanta, GA)
- …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. Please be ... **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
- 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)
- …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
- PruittHealth (Norcross, GA)
- …timeliest manner. 7. Applies knowledge of specific payer billing/payment rules, managed care contracts, reimbursement schedules, eligible provider information ... governmental programs, regulations and billing processes, commercial third-party payers, and/or managed care contracts and coordination of benefits * Familiarity… more