- Humana (Conyers, GA)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Evolent (Atlanta, GA)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Atlanta, GA)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Highmark Health (Atlanta, GA)
- …**JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and knowledge to the team. They support ... the full-cycle ownership of commercial and Medicare Advantage medical policies, both developed internally and by vendors. This includes the writing of clinical… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...of the specific cluster. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- CenterWell (Atlanta, GA)
- …a part of our caring community and help us put health first** A ** Director of Authorizations & Eligibility** is a senior revenue cycle leader responsible for the ... payer approvals to protect revenue integrity and patient access. The Director partners closely with clinical leadership, operations, finance, compliance, and IT,… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Associate Director , Finance Data Management supports all aspects of configuration control, data management, ... and deficiency reporting. The Associate Director , Finance Data Management requires a solid understanding of...PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- CenterWell (Atlanta, GA)
- …a part of our caring community and help us put health first** The Director Denials Management provides leadership for the audit, appeal and review process to ... Manages the Denials Management data analytics, denial and appeal process. The Director , Home Health Grievances & Appeals assists members, via phone or face… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Associate Director , Technology Solution Implementation delivers new technological solutions to meet business ... a specified scope while aligned to enterprise objectives. The Associate Director , Technology Solution Implementation requires a solid understanding of how… more
- Humana (Atlanta, GA)
- …part of our caring community and help us put health first** The Director , Business Systems Analysis leads the strategic advancement, optimization, and integration of ... initiatives that enhance provider experiences and streamline workflows. The Director requires deep expertise in business systems analysis, systems lifecycle… more
- Humana (Atlanta, GA)
- …of our caring community and help us put health first** The Associate Director of Cloud Infrastructure Operations is responsible for leading Humana's enterprise cloud ... at the intersection of operations, technology, and AI innovation. The Associate Director of Cloud Infrastructure Operations will drive the evolution of Humana's… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Director of Finance Portfolio Management, Strategy, & Special Projects is a key leadership role ... focused on continuously improving consumer experiences Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may… more
- Humana (Atlanta, GA)
- …part of our caring community and help us put health first** The Associate Director of IT Disaster Recovery will lead DR operations and governance for all application ... PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Atlanta, GA)
- …accurate documentation specifying rational for approval, or for forwarding to the CMO/ Medical Director for further review. + Create reduction/denial letters ... (PA) requests and ensures that all benefits authorized meet medical necessity and other Medicare and/or Medicaid...based on the CMO/ Medical Director 's review and applicable guidelines. +… more
- Datavant (Atlanta, GA)
- …actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of ... be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care. Interest in...3M360.** You Will: + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references… more
- Humana (Atlanta, GA)
- …segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you ... of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual Medicare… more
- Danaher Corporation (Atlanta, GA)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE ) position is a provider / customer facing role responsible for ... to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the...Value and Access team. This position will be a remote position ideally located in the South East part… more