- Elevance Health (Atlanta, GA)
- …for researching, analyzing, documenting and coordinating the resolution of escalated and/or complex claims issues that span across multiple operational areas and ... Coordinate the identification and resolution of root causes involving configuration, claims and/or contracting activities. **Requirements:** + a BA/BS degree and 5… more
- Elevance Health (Atlanta, GA)
- …a functional resource expert and mentor to unit and other departments for complex issues and interpretation of claims , provider contracts and data, eligibility, ... ** Manager I - Grievances & Appeals -** **Provider...plan and policy changes and to ensure state and federal regulatory compliance and resolution within the regulatory timeframes.… more
- Elevance Health (Atlanta, GA)
- ** Manager II - Grievances & Appeals -** **Provider...in regulated audits. + Serves as a resource for complex issues and interpretation of claims , provider ... Open Access Pulse Points listed in this requisition. **The Manager II - Grievances & Appeals** is responsible for...plan and policy changes and to ensure state and federal regulatory compliance and resolution within the regulatory timeframes.… more
- Morehouse School Of Medicine (Atlanta, GA)
- Insurance & Risk, Manager Bookmark this Posting Print Preview | Apply for this Job Posting Details Position Information About MSM Morehouse School of Medicine ( MSM ... ! Posting Number NONAC3446 Job Title Insurance & Risk, Manager Position Title Insurance & Risk, Manager ...all incidents involving the Institution's assets or stakeholders. Monitor claims activity for erosion of deductibles or SIR .… more
- Stantec (Atlanta, GA)
- …with Earned Value management and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. ... Commercial Project Manager - ( 240002FH ) **Description** We create...be based on Project/Client needs as well as proactive Claims /Risk mitigation. + Oversee and approve development and management… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Manager , Medical Coding in Payment Integrity leads a team that reviews clinical information from ... medical codes (eg, ICD-10-CM, ICD-10-PCS, DRG, APR-DRG) were billed. The Manager , Medical Coding works within specific guidelines and procedures; applies advanced… more
- Southern Company (Atlanta, GA)
- **JOINT USE PROJECT MANAGER ** **Job Summary** **:** The Joint Use Project Manager serves as the subject matter expert for all aspects of joint use, common use ... compliance with Company policy and specifications, and local, state, and federal laws and regulations. The position requires a detail-oriented individual with… more
- Elevance Health (Atlanta, GA)
- **CarelonRx Account Manager II** **Location:** This position will work a hybrid model (remote and office). The ideal candidate must live within 50 miles of one of ... Health PulsePoint locations listed on the requisition. The **CarelonRx Account Manager II** is responsible for retention and operational excellence that… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager I - $3000 Sign-On Bonus Offered** **Location: This is a virtual position, but you must reside in the State of Georgia.** **Work** ... 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager I** is responsible for telephonic care management within the scope of licensure… more
- Cushman & Wakefield (Cartersville, GA)
- **Job Title** Facilities Manager **Job Description Summary** The purpose of this position is to provide leadership and management for the facilities organization at ... a specific location, set of buildings, or campus environment. The Facilities Manager is charged with the day-to-day implementation of policies, procedures, programs… more
- Travelers Insurance Company (Alpharetta, GA)
- …. Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where ... or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent...+ Collaborate with our internal nurse resources (Medical Case Manager ) in order to integrate the delivery of medical… more
- Cushman & Wakefield (Alpharetta, GA)
- **Job Title** Sr. Facilities Manager **Job Description Summary** The Senior Facilities Manager has the overall responsibility for overseeing the implementation ... needs of the building and operations. The Senior Facilities Manager also has responsibility for the overall financial and...expenditures and purchase orders related to the facility(s) or complex * Develop, prepare and explain the annual facility… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Manager , Provider Installation position will manage a Provider Activation Team within the Provider ... Network Operations area under Provider Process & Services. The Manager role is strategic in nature managing multiple work streams with a focus on leveraging… more
- Deloitte (Atlanta, GA)
- Manager , Benefits (Health and Welfare) Recruiting for this role ends on November 20th, 2024. Work you'll do In this role, you will be responsible for managing, ... enabling and executing the US Deloitte LP health & welfare plans. As a Manager , you will lead and provide support for the operation of health and welfare plans… more
- CVS Health (Atlanta, GA)
- …to the defined metrics, as required by the business. Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing ... of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of… more
- Elevance Health (Atlanta, GA)
- …business needs and meet key objectives. + Serves as a resource for complex issues and interpretation of claims , provider contracts and data, eligibility, ... plan and policy changes and to ensure state and federal regulatory compliance and resolution within the regulatory timeframes....Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- PSSI (Atlanta, GA)
- …crucial role in supporting insurance renewals, managing auto-liability and general liability claims , and overseeing certificates of insurance. In this role, you will ... and monitor risks related to team member injuries and compensation claims , while proactively identifying potential risk factors and implementing strategies to… more
- Cardinal Health (Atlanta, GA)
- …insurance benefit practices, preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience preferred + 1-2 years experience with ... or specialty area + Applies advanced skills to resolve complex problems independently + May modify process to resolve...assistance, genetic status or any other status protected by federal , state or local law._ _To read and review… more
- HealthEdge Software Inc (Atlanta, GA)
- …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... and problem-solving skills, including a proven history of rapidly learning complex processes and technologies + Ability to convey difficult messages with… more
- Cardinal Health (Atlanta, GA)
- …knowledge in technical or specialty area * Applies advanced skills to resolve complex problems independently * May modify process to resolve situations * Works ... practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2 years...assistance, genetic status or any other status protected by federal , state or local law._ _To read and review… more