- 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 (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 (Atlanta, GA)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Elevance Health (Atlanta, GA)
- **Product Management Director ** Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our ... Elevance Health PulsePoint locations. The **Product Management Director ** will be responsible for leading the development, implementation, and management of… more
- Evolent Health (Atlanta, GA)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …incentives Ongoing mentorship, development, leadership programs and more! **Description** ** Director , Compliance and Privacy Operations reports to the Chief ... procedures, the code of conduct and new regulatory updates in coordination with Director of Compliance Education. + Assists in, directs, and coordinates the Emory… more
- Centene Corporation (Atlanta, GA)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... Director provides professional judgment to adjudicate prior authorization, claims , and appeals submissions to help Envolve Dental appropriately manage to… more
- Elevance Health (Atlanta, GA)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... This high-performing individual contributor will be responsible for working with management to identify and implement varied projects, programs and plans that… more
- Elevance Health (Atlanta, GA)
- …responsibility for Program Management and/or Medicare Integrity Operations. + Program Management includes but is not limited to: Claims , Grievance & Appeals, ... ** Director I Medicare Operations** **Location:** This position will...years professional/leadership experience with CMS, including strategic planning, project management , Medicare or related healthcare insurance or medical… more
- J&J Family of Companies (Atlanta, GA)
- …safety data, international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and implements ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...position is to lead the implementation of the Signal Management Group's aggregate surveillance strategies for proactive and systematic… more
- Cardinal Health (Atlanta, GA)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Sumitomo Pharma (Atlanta, GA)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
- 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
- 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
- Evolent Health (Atlanta, GA)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Sedgwick (Atlanta, GA)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director SAP Program **PRIMARY PURPOSE** **:** Directs the strategic planning, ... of SAP FICO and BRIM Solution Components, including Subscription Order Management (SOM), Convergent Charging (CC), Convergent Invoicing (CI), Contract Accounting… more
- Evolent Health (Atlanta, GA)
- …models using healthcare data (ie, both structured and unstructured data from operations, claims , and medical charts) to solve complex problems, drive innovation, ... in everything from scrubs to jeans. **Position summary** As an Associate Director , Data Scientist (Machine Learning Engineer), you will be responsible for… more
- Southern Company (Atlanta, GA)
- …and assistance to Director of Claims , injured employees, Claims Manager, Legal Department, business units, medical and legal professionals, excess ... + Actively pursue subrogation and second injury fund recoveries. **Engagement:** + Coordinate all claims management and return to work efforts with the nurse and… more
- State of Georgia (Fulton County, GA)
- …- Position Overview: OMC/HSI Budget and Financial Analyst reports to the Director of the Office of Medicaid Coordination and Health Systems Innovation. The ... product lines. Duties and Responsibilities: Under the broad supervision of the Director of the Office of Medicaid Coordination and Health Systems Innovation,… more
- 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