- Humana (Atlanta, GA)
- …of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and ... financial, and clinical teams to assess and determine optimal data solutions. Provide strategic recommendations on ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- CVS Health (Atlanta, GA)
- …all with heart, each and every day. **Position Summary** - Maintains the Provider Data (demographic and contractual) for all network and non-network providers. ... other departments regarding database improvements. - Provides support for baseline provider data transactions that cannot be administered automatically through… more
- Humana (Atlanta, GA)
- …+ Deliver project-based and ad-hoc reporting for Medicaid markets; provide insights into membership analysis, provider performance, RFPs, and market ... The Senior Market Finance Professional supports more than half of Humana's Medicaid business, providing technical financial analysis and data -driven insights to… more
- PruittHealth (Norcross, GA)
- … forms to Georgia Gateway 6. Follow-up with DFCS routinely using the Medicaid Provider Status Request spreadsheet 7. Document follow-up with EDWP clients ... follows up with the Division of Family and Children Services (DFCS) to ensure the clients' eligibility process is...and DFCS via the DCH/DDS electronic data system 8. Verify Medicaid eligibility or… more
- Humana (Atlanta, GA)
- …Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing ... Engineer will be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities. They will… more
- Humana (Atlanta, GA)
- …of the care received by members in the KY, OH, VA, WI and IN Medicaid market populations. May provide cross-coverage for other state Medicaid markets. ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Deloitte (Atlanta, GA)
- …work. Recruiting for this role ends on December 15th, 2025.Work You'll Do + Provide strategic and technical consulting services to public sector clients + ... reimbursement, including actuarial rate development across managed care and fee-for- service , Medicaid policy, budget forecasting and fiscal analyses, and… more
- Molina Healthcare (Atlanta, GA)
- …as subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, ... to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard reports to monitor health plan performance and identify the… 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...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and… more
- Public Consulting Group (Atlanta, GA)
- …agency and school district clients in their efforts related to special education, Medicaid reimbursement, data management and use. While a remote role, it ... and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000… more
- Humana (Atlanta, GA)
- …fraud, waste and abuse within the healthcare industry + Knowledge of the Medicare and Medicaid programs + Experience in data analysis + Must be passionate about ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Atlanta, GA)
- …Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention to detail ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Humana (Atlanta, GA)
- …into provider -friendly insights. + Lead the design and refinement of provider -facing data views (dashboards, insights, performance summaries) to ensure they ... provider workflows. + Work with product leads and data teams to prioritize enhancements that make insights easier...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
- CVS Health (Atlanta, GA)
- …the process for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners. . Developing relationships with leaders of ... chronic kidney, oncology, polychronic/complex care, and emerging specialty types) or Medicaid provider organizations to design and execute on strategies… 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. ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… 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. ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
- Intermountain Health (Atlanta, GA)
- …of provider enrollment with commercial and government (Medicare and Medicaid ) professional fee payer contracts for an entire market. Ensures enrollment is ... to stakeholders. Keeps detailed notes about enrollment progress in provider enrollment database and distributes information to designated department representatives… 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. ... help us put health first** The Associate Director, Finance Data Management supports all aspects of configuration control, ...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… 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. ... first** We are looking for a highly capable Senior Data Scientist to support advanced AI initiatives focused on...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more