- WTW (Atlanta, GA)
- …Wealth and Career and Risk and Broking. The Managed Care Growth Leader is the primary client lead managing the totality of the Willis Towers Watson ... (WTW) relationship for clients within the Managed Care Industry. This individual is accountable...business while managing existing revenue and profit streams + Lead the development and execution of client account plans… more
- Elevance Health (Atlanta, GA)
- …or related field and a minimum of 3 years' experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Provider Contract Cost of Care Analyst Senior** **Location:** This position will work...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Atlanta, GA)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Provider Contract/Cost of Care Analyst Sr.** **Location:** This position will work...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Atlanta, GA)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Provider Contract/Cost of Care Consultant** **Location:** Target locations include Chicago-IL, New...Works on complex enterprise-wide initiatives and acts as project lead . * Uses analytic tools to track both health… more
- Elevance Health (Atlanta, GA)
- …or related field and a minimum of 7 years' experience in broad-based analytical, managed care payor or provider environment as well as in depth experience ... **Provider Contract Cost of Care Consultant Senior** **Location:** This position will work...Works complex, large-scale enterprise-wide initiatives and acts as project lead . + Uses analytic tools to track both health… more
- Elevance Health (Atlanta, GA)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Provider Contract/Cost of Care Consultant** **Location:** This position will work a...Works on complex enterprise-wide initiatives and acts as project lead . **How you will make an impact:** * Creates… more
- Elevance Health (Atlanta, GA)
- …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... acute care clinical experience or case management, utilization management or managed care experience; or any combination of education and experience, which… more
- Elevance Health (Atlanta, GA)
- …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... acute care clinical experience or case management, utilization management or managed care experience; or any combination of education and experience, which… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …national level. + Use available tools and resources to monitor and evaluate industry/ managed care trends and communicate relevant information to those who are ... those objectives. You will report to the Regional Business Lead - HEM. Mid-Atlantic Region Consists of the following...impacted (ie Sales Forces, Leadership, and Managed Care Accounts). + Work within established… more
- Cardinal Health (Atlanta, GA)
- …intersection of 340B and Medicaid, including duplicate discounts, fee-for-service versus managed care , medical versus pharmacy, and entity-owned versus contract ... asset - delivering value that supports the patient throughout the continuum of care . The team's mission is to provide exceptional clinical, supply chain, analytics,… more
- Humana (Atlanta, GA)
- …**Preferred Qualifications** + **Understands Medicare Inpatient Guidelines** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
- Humana (Atlanta, GA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Atlanta, GA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …level. + Appropriately uses available tools and resources to monitor and evaluate industry/ managed care trends and communicate relevant information to those who ... are impacted (ie Sales Forces, Leadership, SFE Lead , Marketing and Market Access) + Works within established...and adaptability to changing market conditions + Understanding of managed care landscape and how it influences/impacts… more
- Public Consulting Group (Atlanta, GA)
- …CMS regulations governing Medicaid reimbursement, including the rehabilitation option, EPSDT, managed care , state plan amendments, Medicaid waivers and ... CMS regulations governing Medicaid reimbursement, including the rehabilitation option, EPSDT, managed care , state plan amendments, Medicaid waivers and… more
- Evolent Health (Atlanta, GA)
- …/ or business experience in an HMO / PPO Claims, Medicaid, Medicare and / or managed care healthcare environment + Knowledge of the Affordable Care Act, HMO ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...we seek to connect the pieces of fragmented health care system and ensure people get the same level… more
- Elevance Health (Atlanta, GA)
- …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... to interpret and apply member contracts, member benefits, and managed care products preferred. + Certification as...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- CenterWell (Atlanta, GA)
- …**Preferred Qualifications** + Basic knowledge of Population Health Strategy + Medicare knowledge + Managed care experience + Value Based Care knowledge + ... TB. + Direct leadership experience and demonstrated ability to lead , coach and mentor teams + Proven interpersonal skills...of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial… more
- Elevance Health (Atlanta, GA)
- …care setting preferred. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... **Telephonic Nurse Case Manager II** is responsible for performing care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …opportunities and adaptability to changing market conditions + Demonstrated understanding of managed care landscape and how it influences/impacts business + ... Regional Business Manager, you will analyze local and regional business/ managed markets trends in order to build both long...to build both long and short terms goals that lead to a successful business plan. + Work compliantly… more