- Cardinal Health (Atlanta, GA)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- Molina Healthcare (Atlanta, GA)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Hilton (Atlanta, GA)
- …franchised Hilton hotels world\-class revenue management talent and tools\. As a Revenue Manager , RMCC, Managed , you will support the team that's helping hotels ... grow market share and outperform competitors\. On the Managed team reporting to the Assistant Director, you will...savings account, an employee assistance program, access to a care coordination program \("Wellthy"\), a legal services program, an… more
- Molina Healthcare (Atlanta, GA)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Indeed (Atlanta, GA)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- Molina Healthcare (Atlanta, GA)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- Molina Healthcare (Atlanta, GA)
- …Qualifications** * At least 3 years of experience in a pharmacy, Pharmacy Benefit Manager (PBM), formulary, and/or managed care setting, and 1-2 years ... team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all current Molina… more
- Elevance Health (Atlanta, GA)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental ... hours with** **some weekends based upon organizational/business needs.** The **Behavioral Health Care Manager II** is responsible for managing psychiatric and… more
- Molina Healthcare (Atlanta, GA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Humana (Atlanta, GA)
- …+ BSN or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see ... part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'… more
- Elevance Health (Atlanta, GA)
- **Behavior Health Care Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law._ The **Behavior Health Care Manager II** will be responsible for...range of experience with complex psychiatric/substance abuse cases required.Prior managed care experience required. + Current active… more
- Gentiva (Stockbridge, GA)
- **Overview** 7,500 SIGN ON BONUS We're looking for a **Patient Care Manager Senior** to join our team. You will report directly to the Executive Director or ... of terminally ill patients and their families. + Thorough knowledge of managed care principles, regulatory guidelines (ie, Medicare, Medicaid, JCAHO, ACHC,… more
- CenterWell (Decatur, GA)
- …in a Cardiology setting + Bachelor's Degree + Bilingual in both English and Spanish + Managed care experience + Value Based Care knowledge + Proven ability ... help us put health first** **Job Description Summary** The ** Manager , Clinic/Center Administration** plans and directs the work of...of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial… 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 ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management...Nurse Case Manager II** is responsible for care management within the scope of licensure for members… more
- CDM Smith (Atlanta, GA)
- …CDM Smith currently has a new opportunity for a Senior Project Manager with previous experience managing industrial water and/or wastewater projects to join ... Smith's mission by: * Managing and serving as the lead Project Manager on water/wastewater projects * Providing technical guidance, senior leadership, and mentoring… more
- Medtronic (Atlanta, GA)
- …connected, compassionate world. **A Day in the Life** The Sr. IT Program Manager - Collaboration, will be responsible for the strategic and operational leadership of ... driving service excellence, and managing a global team, including offshore managed service providers. The ideal candidate will bring deep technical expertise,… more
- CenterWell (Marietta, GA)
- …you to sit on-site at our Marietta, GA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services provided by ... a part of our caring community and help us put health first** The Clinical Manager , Home Health Nursing enables patients to stay in their homes by providing health… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …policies and procedures to comply with medial staff bylaws, hospital bylaws, managed care policies, TJC/NCQA requirements and related state and federal ... + Five (5) years comprehensive Medical Staff Services in an acute care hospital, managed care or credentialing verification organization with three (3) years… more
- CAI (Atlanta, GA)
- Case Manager , RN **Req number:** R6346 **Employment type:** Full...+ Minimum of 3 years of experience in Acute Care , Managed Care , or experience ... **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next...critical role in holistic assessment, planning, coordination, and monitoring care to optimize member health outcomes while advocating for… more
- Molina Healthcare (Atlanta, GA)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to...medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles… more