• Medicare Provider Performance

    The Cigna Group (Atlanta, GA)
    …market, incumbent candidate will work from local office 3 days per week.** The Provider Performance Enablement Advisor is an integral part of a cross-functional, ... collaborative organization (which includes Market Provider Performance , Sales, Clinical Operations, Stars &...members contribute to the growth and profitability of the Medicare Advantage business in their market in the following… more
    The Cigna Group (08/27/24)
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  • Medicare Strategy Lead

    Humana (Atlanta, GA)
    …with an emphasis on Medicare Advantage strategy development. As a Medicare Strategy Lead , you will deconstruct issues and challenges, perform targeted ... in the country. Location: remote The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, comprises… more
    Humana (09/06/24)
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  • Behavioral Health Medical Director…

    Humana (Atlanta, GA)
    …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid requirements, and will understand how ... will attend and participate in meetings involving care management, provider relations, quality of care, audit, grievance and appeal...an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing… more
    Humana (08/07/24)
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  • Medical Director - National Medicare Team

    Humana (Atlanta, GA)
    …teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to ... an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age)....reports to a Regional Vice President of Health Services, Lead , or Corporate Medical Director, depending on size of… more
    Humana (08/29/24)
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  • Marketing Advisor, DTC Advertising & Sales Support…

    The Cigna Group (Atlanta, GA)
    …Cigna's Medicare PDP growth goals. **Responsibilities** + Partner to provide the strategic direction and management of digital acquisition marketing initiatives ... and executed to advance the company's goals. + Utilize data analytics and performance tracking tools to monitor campaign performance , identify trends, and… more
    The Cigna Group (08/14/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Atlanta, GA)
    …clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate about contributing ... be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet… more
    Humana (08/10/24)
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  • Director Provider Quality Outcomes

    Highmark Health (Atlanta, GA)
    …supporting and developing technology and data strategies to support STARs performance , and developing provider incentive programs. Works collaboratively with ... STARs quality strategy, support/develop technology and data strategies to support STARs performance , and provider incentive programs in partnership with senior… more
    Highmark Health (08/10/24)
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  • Delaware Valley ACO Fellowship/ Provider

    Humana (Atlanta, GA)
    …grouping, with more than 2,000 physicians and approximately 70,000 Medicare fee-for-service beneficiaries. Additionally, DVACO currently holds performance -based ... (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus… more
    Humana (06/24/24)
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  • Provider Contract/Cost of Care Consultant

    Elevance Health (Atlanta, GA)
    performance using summary statistical procedures. * Develops and analyzes business performance reports (eg for revenue, claims, provider , member, and ... **Anticipated End Date:** 2024-10-07 **Position Title:** Provider Contract/Cost of Care Consultant **Job Description:** **...Works on complex enterprise-wide initiatives and acts as project lead . **How you will make an impact:** * Creates… more
    Elevance Health (09/07/24)
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  • Risk Adjustment Strategic Partnership Lead

    Humana (Atlanta, GA)
    …with Group Medicare leadership to ensure collaborative insights and performance alignment. The Program Delivery Lead spearheads the development of ... our caring community and help us put health first** As a Program Delivery Lead specializing in Risk Adjustment Strategic Partnerships, you will lead the… more
    Humana (08/28/24)
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  • Enterprise Utilization Clinical Decision-Making…

    Humana (Atlanta, GA)
    …and help us put health first for our members, providers and ourselves. Desired Lead Associate to lead and manage the enterprise framework to facilitate and ... actions when controls indicate process gaps. + Review appeal overturns and provider complaints about coverage policies to make necessary changes. + Driving… more
    Humana (09/04/24)
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  • Strategy Advancement Lead - Clinical…

    Humana (Atlanta, GA)
    …identify and address business issues and opportunities related to the high-needs Medicare Advantage (MA) and Special Needs Plan (SNP) populations that benefit from ... will focus on opportunities to improve member health outcomes, member and provider experience, clinical quality, and savings to medical costs. The Strategy… more
    Humana (09/04/24)
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  • Capture Lead , Medicaid Clinical…

    Humana (Atlanta, GA)
    …and Medicare integration, D-SNPs, and Self-Directed Services. The Capture Lead , Medicaid Clinical & Population Health Strategy key responsibilities include: + ... and help us put health first** Humana Healthy Horizons is seeking a Capture Lead , Clinical & Population Health Strategy, to lead initiatives developing and… more
    Humana (08/15/24)
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  • Lead Google Cloud Solutions Engineer,…

    Humana (Atlanta, GA)
    …a part of our caring community and help us put health first** The Lead Cloud Solutions Engineer (Network) is responsible for the planning, design, and engineering of ... infrastructure and platforms related to cloud network & cloud computing. The Lead Cloud Solutions Engineer (Network) provides strategic advice and guidance to… more
    Humana (08/20/24)
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  • Financial Analytics Lead

    Humana (Atlanta, GA)
    …us put health first** CenterWell's Value-Based Organization is an integrated homecare service provider focused on meeting the needs of Health Plans by serving its ... shared savings) deals with health plans and other risk-bearing groups to provide home health, DME, and home infusion services. **Responsibilities:** The Value-Based… more
    Humana (08/31/24)
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  • Lead Actuary

    Humana (Atlanta, GA)
    …a part of our caring community and help us put health first** The Lead Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... provide accurate and timely information for strategic and operational...short, medium and long-term financial and competitive position. The Lead Actuary, Analytics/Forecasting works on problems of diverse scope… more
    Humana (08/30/24)
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  • Lead DevOps Engineer

    Humana (Atlanta, GA)
    …responsibility for all of Insurance IT to improve productivity and efficiency. The Lead DevOps engineer will be a key investment towards that productivity gain and ... to improve DevOps maturity overall. The Lead engineer will enable Insurance IT expedite access remediation, certified template migration, and improving standards… more
    Humana (08/30/24)
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  • Lead Application Architect (Integrated…

    Humana (Atlanta, GA)
    …vision resonates with you, we would like to talk to you! The Lead Application Architect designs and develops IT applications architecture solutions to business ... alignment with the enterprise architecture direction and standards. The Lead Application Architect works on problems of diverse scope...Requirements** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a… more
    Humana (07/04/24)
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  • Organization Effectiveness Lead

    Humana (Atlanta, GA)
    …our caring community and help us put health first** The Organization Effectiveness (OE) Lead will lead strategic organizational changes with a primary focus on ... enterprise and corporate functions. The OE Lead will report to the Director, Organization Effectiveness. Primary Responsibilities: + Collaborate with senior-level… more
    Humana (09/06/24)
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  • Lead Agile Coach

    Humana (Atlanta, GA)
    …a part of our caring community and help us put health first** The Lead Agile Coach coaches, educates and mentors organizational leaders and their teams to instill ... methodologies and practices including Scrum, Kanban and Scaled Agile Framework (SAFe). The Lead Agile Coach works on problems of diverse scope and complexity ranging… more
    Humana (09/07/24)
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