- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- CVS Health (Atlanta, GA)
- …skills and attention to detail **Preferred Qualifications** + Previous Pharmacy or Medicare Part D experience + FSA designation + Experience with SAS, SQL, ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… more
- CVS Health (Atlanta, GA)
- …and affordable. **Position Summary** As the Manager, FP&A, you will report directly to Director of Finance and will monitor the end to end profit & loss statements, ... data submission for the purpose of rate setting and medical trend analysis on behalf of the Health Plan....nature of this remote role, candidates must have some Medicare and/or Medicaid experience. **Required Qualifications** -5 or more… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CenterWell (Stone Mountain, GA)
- …a part of our caring community and help us put health first** The Associate Medical Director serves as a health-care professional and capable of handling a ... variety of health-related problems. The Associate Medical Director requires a solid understanding of...**Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- Molina Healthcare (Atlanta, GA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Evolent (Atlanta, GA)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Atlanta, GA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , you will be a key member of the utilization management team. ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- CVS Health (Atlanta, GA)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
- Evolent (Atlanta, GA)
- …$64M of savings for Medicare in the Shared Savings Program. The Managing Director will report to the SVP Primary Care / President of Evolent Care Partners and ... Medicare and Commercial contracts, including plans related to medical expense management, quality improvement, appropriate risk adjustment, and patient and… more
- Genesis Healthcare (Roswell, GA)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... expertise with our Clinicians in Action professional development program. Responsibilities The Director of Rehab PT is responsible for the efficient management of… more
- Humana (Atlanta, GA)
- …of our caring community and help us put health first** The Associate Director , Actuarial provides actuarial support across a broad range of actuarial and business ... needs for specific product lines. The Associate Director , Actuarial requires a solid understanding of how organization capabilities interrelate across department(s).… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …to the best of my knowledge. **Job Description** **Regional Account Director ** **Takeda Pharmaceutical** **USA-MA-Virtual** **About the role:** Are you looking for ... you to shine? Join us as the Regional Account Director ; reporting into the Head of Corporate Accounts. This...accounts. Responsible for all books of business - Commercial, Medicare , State Medicaid and Managed Medicaid + Gain, protect… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing architectures and ... and unstructured data to insights at enterprise scale. The Associate Director , Cloud Architecture requires an in-depth understanding of how organization capabilities… more
- United Therapeutics (Atlanta, GA)
- …orphan diseases. **How you'll contribute** The Associate Analytics, Insights and Operations Director , Market Access will lead data support across all functions of ... Compliance, Legal, Information Technology, Sales & Marketing Operations, Finance, and Medical Affairs / HEOR. Additionally, this role will support special pricing… more
- Elevance Health (Atlanta, GA)
- …care. CarelonRx's Pharmaceutical Rebates Org is looking to hire a ** Director , Formulary Strategy Development.** This high-performing individual contributor will play ... in driving affordability across multiple lines of business (Commercial, Medicaid, Medicare , ASO clients) by partnering with internal and external stakeholders to… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** A Waystar Regional Director must effectively communicate with target account senior leaders and executives, and coordinate strategy with ... systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out...+ bonus, if applicable) + Customizable benefits package (3 medical plans with Health Saving Account company match) +… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Director of Trade Shows + Events will be responsible for the strategic planning and execution of all trade shows, user groups, and ... systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out...+ bonus, if applicable) + Customizable benefits package (3 medical plans with Health Saving Account company match) +… more