- Molina Healthcare (Macon, GA)
- …Design. Provides subject matter expertise and leadership to healthcare services function - providing support for project/ program /process design, execution, ... into functional requirements. + Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality… more
- Molina Healthcare (Macon, GA)
- …in Georgia. JOB DESCRIPTION Job Summary Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following ... and application of protocols and guidelines. + Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources,… more
- Molina Healthcare (Macon, GA)
- **Job Description** **Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment department to assist our diverse team of ... medical loss ratio (MLR) targets. In conjunction with the Manager of the In-Home Assessment Program , this...Programs, Market & Segment Leaders, health plan teams, member services , provider services , external vendors, actuary, and… more
- Molina Healthcare (Macon, GA)
- **JOB DESCRIPTION** Job Summary: The AI Program Manager serves as a strategic leader driving the execution of AI initiatives to deliver meaningful business ... process improvement and organizational change management to operationalize the AI program vision. This includes end-to-end program planning (estimating,… more
- Molina Healthcare (Macon, GA)
- …Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team ... processes. * Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate… more
- Molina Healthcare (Macon, GA)
- …quality and cost-effective member care. This position will support our Molina One Care Services business in Massachusetts. We are looking for a candidate with a MA ... for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services...resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and… more
- Compass Group, North America (Macon, GA)
- …professional food service team members. **Job Summary** We are seeking a **Patient Services Manager ** to lead our Patient Services Team in an Acute ... **Morrison Healthcare ** is a leading national food and nutrition services company exclusively dedicated to serving more than 600 hospitals and healthcare… more
- Molina Healthcare (Macon, GA)
- …to improve member quality of life and to control costs. + Train/educate healthcare services staff on professional standards of documentation + Reeducate staff ... that align with Molina programs and protocols + Assists Manager with data for team member performance reviews +...quality of life and to control costs. + Train/educate healthcare services staff on professional standards of… more
- Molina Healthcare (Macon, GA)
- …Responsible for creating, operating, and monitoring Molina Health Plan's pharmacy services programs in accordance with all federal and state laws. ... **Knowledge/Skills/Abilities** + Monitor the operational aspects of the Pharmacy Benefits Manager and other delegates to assure compliance with contractual and… more
- Bridgestone Americas (Warner Robins, GA)
- …equivalent. + 4 years of auto service technical experience. + 1 year of service manager or service writer experience. + Problem solving - customer ... locations across North America and more than $4.5 billion in tire and auto service sales, Bridgestone Retail Operations is the right place to build a career.… more
- Emory Healthcare/Emory University (Warner Robins, GA)
- …or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status or any other ... **Overview** **Emory Healthcare . Where you matter as much as the...with or referrals to other medical professional or community services . + Educates patient on health habits, self-examinations, behavior… more
- Genesis Healthcare (Marshallville, GA)
- …children at home and in school. With over 38 years of trusted service , our reach spans skilled nursing centers, assisted and independent living facilities, ... + **Support for New Grads:** Our Powerback Clinical Mentorship Program kicks off on day one, helping you learn...new way of delivering recovery, rehabilitation, respiratory, and wellness services to patients across the nation. We deliver an… more
- Molina Healthcare (Macon, GA)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan ... of service . **KNOWLEDGE/SKILLS/ABILITIES** + Follows member throughout a 30-day program that starts at hospital admission and continues through transitions from… more
- Molina Healthcare (Macon, GA)
- …Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified ... National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and… more
- Molina Healthcare (Macon, GA)
- …oversight and expertise related to behavioral health and chemical dependency services , and assists with implementation of integrated behavioral health care programs ... management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize… more
- Molina Healthcare (Macon, GA)
- …Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an ... Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional… more
- Molina Healthcare (Macon, GA)
- …medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for ... Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports plan utilization management program… more
- Molina Healthcare (Macon, 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, ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, Overpayment… more
- Walgreens (Warner Robins, GA)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... services as required; assists pharmacy staff in coordination of clinical services , Walgreens healthcare clinics and external providers. + Assists Pharmacy … more
- Walgreens (Warner Robins, GA)
- …to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs ... services as required; assists pharmacy staff in coordination of clinical services , Walgreens healthcare clinics and external providers. + Assists Pharmacy … more