- Reach Out and Read (Atlanta, GA)
- …and Read champions and advocates from each clinic's medical providers and staff. Provide regular and ongoing technical assistance and support to all programs to ... in place for their providers, so that existing and new providers can provide a high-quality program. Develop and implement efforts to prioritize and expand programs… more
- MultiPlan (Atlanta, GA)
- …we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to ... journey as we optimize the opportunity towards becoming a leading technology, data , and innovation voice in healthcare. Onward and Upward JOB SUMMARY: This… more
- CVS Health (Atlanta, GA)
- … provider relationships. **What you will do** + Coordinates the provider data management process by collecting, organizing, and maintaining accurate ... networks or panels. + Ensures compliance with regulatory requirements related to provider data , as outlined by government agencies, accrediting bodies, or… more
- Mathematica (Atlanta, GA)
- …related to monitoring and improving the following Medicaid programs: Medicaid payment and financing policies (fee-for- service base and supplemental payments, ... rigorous analytic thinking to the collection and interpretation of quantitative and qualitative data , including analysis of Medicaid administrative data and… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our ...federal and state government to define health plan covered service packages and eligible cohorts. + Communicate covered services… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize,… more
- Public Consulting Group (Atlanta, GA)
- …new streamlined modular certification (SMC) and outcomes-based certification (OBC). Our ideal Medicaid Consultant will provide oversight and direction for scope, ... achieve strategic goals to serve the public better. We provide the full spectrum of technology consulting services to...Business Enablement + Business Solutions + Project Assurance The Medicaid marketplace is changing, and PCG is at the… more
- Prime Therapeutics (Atlanta, GA)
- …the implementation and support of all activities related to developing and maintaining service provider contracts. Interacts with all areas of the Prime ... empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more
- Highmark Health (Atlanta, GA)
- …to evaluate the medical necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic peer to peer discussions ... as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA,… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and… more
- Prime Therapeutics (Atlanta, GA)
- …empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If ... drives every decision we make. **Job Posting Title** Health Data Analyst - Remote **Job Description** The Health ...new products + May be responsible for Centers for Medicaid /Medicare Services reporting and analysis, including the management of… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... us put health first** Join our team as a Data Visualization Engineer 2 and revolutionize how we interact...the US without Humana sponsorship as Humana does not provide work visa sponsorship for this role._** **Location/Work Style:**… more
- CenterWell (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... play critical role in defining and executing Integrated Health data strategy and oversee the creation of trusted, cross-domain...Please be aware that applicants may be asked to provide their Social Security Number, if it is not… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... health first** The role of the Vice President, Enterprise Data Governance & Protection is to lead Humana's ... capabilities are effectively integrated into business execution. + Provide expertise, consult and lead innovation, tap into new… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... community and help us put health first** The Senior Data Scientist uses mathematics, statistics, modeling, business analysis, and...achieve their best health - delivering the care and service they need, when they need it. These efforts… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The...services, requested level of care, and/or requested site of service should be authorized. All work occurs within a… more
- Highmark Health (Atlanta, GA)
- …onboarding of new plans/providers. Translates configuration rules, fee schedules, contract terms, provider data code sets, and benefits into systems parameters ... underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change management… more
- Humana (Atlanta, GA)
- …Communicate insights and analytical findings to a broad range of audiences * Ensure solutions provide the highest quality of data * Contribute to moving the team ... towards cloud-based analytical platforms Member and Provider Analytics, the department this role is a part...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- Humana (Atlanta, GA)
- …and Claims Analytics (PICA) team solve complex business problems and issues using data from internal and external sources to provide insights to decision-makers. ... the appropriate courses of action. About Our Team The Provider Intelligence and Claims Analytics (PICA) team is a...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- Humana (Atlanta, GA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... health plan performance. They promote cross functional strategic initiatives using data and trend analysis and quality improvements, establishing long range goals,… more
