- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… more
- Humana (Decatur, GA)
- …of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll ... 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… more
- CenterWell (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Evolent (Atlanta, GA)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** +...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Atlanta, GA)
- …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications -...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Atlanta, GA)
- …MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Humana (Atlanta, GA)
- …those customers at the center of everything it does." The Associate Director , Sales Support oversees a team of contracting professionals. Their primary ... carriers for the Humana sales brokerage, Innovative Financial Group (IFG). The Associate Director , Sales Support requires a solid understanding of the Medicare … more
- Evolent (Atlanta, GA)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Danaher Corporation (Atlanta, GA)
- …to effectively coordinate and engage targeted customers within the US. Reporting to the Senior Director of Market Access Americas, this highly visible role will ... the Danaher Business System which makes everything possible. The Field Reimbursement Director position is a provider / customer facing role responsible for… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Director , Financial Planning & Analysis - Specialty analyzes and forecasts financial, economic, and ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Internal Audit Director is a critical leadership role responsible for developing, implementing, and overseeing the internal audit ... delivery of high-quality audit results across the company. The Director will work closely with executive leadership and the...and present audit findings, recommendations, and action plans to senior management and the Audit Committee. + Monitor and… more
- Baylor Scott & White Health (Atlanta, GA)
- … senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key ... **Job Summary** The Director , Denial Resource Center is responsible for the...improved utilization of appropriate patient care services. Collaborates with medical , clinical, HIM and other BSWH departments to ensure… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** Associate Director of Project Management to join the Readiness and Recovery team, focusing on ... experiences, drive transformation, and support enterprise goals. The Associate Director will ensure alignment of project initiatives with business objectives,… more
- Molina Healthcare (Atlanta, GA)
- …activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Gentiva (Stockbridge, GA)
- …functions, including documenting referrals, new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining ... ON BONUS We're looking for a **Patient Care Manager Senior ** to join our team. You will report directly...our team. You will report directly to the Executive Director or Administrator. You will be responsible for assisting… more
- Danaher Corporation (Atlanta, GA)
- …commercial customer engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value ... Danaher Business System (https://www.danaher.com/how-we-work/danaher-business-system) which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position is a… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Medicine. The clinical performance will be evaluated by the Emergency Department Medical Director /Service Chief of the fellow's base hospital and reviewed ... Health System. Fellows must be eligible at participants in Medicare , Medicaid and other third-party payers contracted with Emory...programs affiliated hospitals under the direction of the ED director of that hospital + May supervise medical… more
- CenterWell (Marietta, GA)
- …participant and lead with the care team through daily huddles. . Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of ... one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over...to write prescriptions under the authority of a collaborating physician/ medical director + This role is considered… more
- CenterWell (Atlanta, GA)
- … medical expertise with the care team through daily huddles. . Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over 350 centers across… more
- Humana (Atlanta, GA)
- …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... company's total revenue and earnings. Team members partner with senior leaders of the business unit, and more broadly...initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the… more