• Medical Director -- Claims

    Humana (Atlanta, GA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (10/29/24)
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  • Complex Claims Director - Federal…

    AIG (Atlanta, GA)
    … and legal aspects of assigned claims using available resources which include medical management services to manage medical treatment and coordinate use ... help customers to manage risk. Join us as a Complex Federal Work Comp Claims Director to play your part in that transformation. It's an opportunity to grow your… more
    AIG (10/19/24)
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  • Director - Complex Claims

    Sedgwick (Atlanta, GA)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... negotiation, mediation, arbitration, or ADR skills on higher value complex claims . Management experience preferred. Specific jurisdictional expertise required.… more
    Sedgwick (12/17/24)
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  • Medical Director - Florida

    Humana (Atlanta, GA)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (12/14/24)
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  • Reviewing Medical Director

    Conviva (Atlanta, GA)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… more
    Conviva (12/11/24)
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  • Medical Director - National Medicare…

    Humana (Atlanta, GA)
    management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
    Humana (11/08/24)
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  • Director , Medical Affairs - NYC…

    Merck (Atlanta, GA)
    **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
    Merck (12/19/24)
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  • Corporate Medical Director

    Humana (Atlanta, GA)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (11/27/24)
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  • RN Traveling Director of Nursing

    Brookdale Senior Living (Atlanta, GA)
    Overview Traveling RN Director of Nursing Opportunity! Required experience: + 5+ years within a Skilled Nursing Facility + Prior Director of Nursing experience, ... within community until a replacement is identified, then supports newly assigned Director of Clinical Services, Assistant Director of Clinical Services, and/or… more
    Brookdale Senior Living (12/07/24)
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  • Managing Director - Insurance Advisory…

    EPAM Systems (Atlanta, GA)
    …driving strategic and operational excellence across client functions such as underwriting, claims and distribution management . You will contribute to the ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more
    EPAM Systems (12/18/24)
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  • Director of International, Global Household…

    HomeSafe Alliance (Atlanta, GA)
    **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
    HomeSafe Alliance (12/21/24)
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  • CE Strategic SCM Director 1

    Celestica (Atlanta, GA)
    …**Functional Area:** Supply Chain Management (SCM) **Career Stream:** Supply Chain Management (SCM) **Role:** Director 1 (DR1) **Job Title:** Director , ... a dynamic market environment. **Detailed Description** We are currently seeking a ** Director , Strategic Supply Chain Management (Capital Equipment)** to join our… more
    Celestica (12/20/24)
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  • Director Healthcare Economics & Trend…

    Baylor Scott & White Health (Atlanta, GA)
    claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… more
    Baylor Scott & White Health (12/21/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Atlanta, GA)
    …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
    Takeda Pharmaceuticals (10/16/24)
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  • Director Global Accounts Payable

    Sedgwick (Atlanta, GA)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Global Accounts Payable **PRIMARY PURPOSE OF THE ROLE:** The Global ... Director of Accounts Payable is responsible for leading the...across the AP team through training, coaching and performance management . + Continually evaluates processes, systems for improvement. +… more
    Sedgwick (12/20/24)
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  • Operations Supervisor - Move Management

    HomeSafe Alliance (Atlanta, GA)
    **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
    HomeSafe Alliance (10/02/24)
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  • Care Management Associate

    CVS Health (Atlanta, GA)
    …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers,...- May assist in the research and resolution of claims payment issues. - Supports the administration of the… more
    CVS Health (12/21/24)
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  • Nurse Investigator

    State of Georgia (Fulton County, GA)
    …additional experience in the analysis of medical services documentation and related claims 2) Utilization Review 3) Case Management 4) Analysis of CPT codes ... Job Summary Under the direction of the Fraud Unit Director , assists in healthcare investigations by: reviewing provider and...clinical experience AND one (1) year experience working with medical claims . Preference will be given to… more
    State of Georgia (12/20/24)
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  • Coordinator, Intake Utilization Management

    Evolent (Atlanta, GA)
    …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
    Evolent (12/04/24)
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  • Coordinator, Utilization Management

    Evolent (Atlanta, GA)
    …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
    Evolent (12/24/24)
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