• Managed Care Leader

    WTW (Atlanta, GA)
    …Wealth and Career and Risk and Broking. The Managed Care Growth Leader is the primary client lead managing the totality of the Willis Towers Watson ... (WTW) relationship for clients within the Managed Care Industry. This individual is accountable...business while managing existing revenue and profit streams + Lead the development and execution of client account plans… more
    WTW (07/25/24)
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  • Director, Managed Care - Navista

    Cardinal Health (Atlanta, GA)
    …strategic, business development, and contracting activities related to the Managed Care environment. They will be a seasoned leader and advisor, with ... team is passionate about helping oncology practices navigate the future. The Director, Managed Care is responsible for strategy and management of managed more
    Cardinal Health (08/14/24)
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  • Director, Sales & Business Development…

    Cardinal Health (Atlanta, GA)
    …to the National VP of Sales, the Director, Sales & Business Development - Managed Care is an individual contributor, executive sales position. This individual ... at decision-makers and decision influencers at existing and new managed care accounts. This individual must be...skills, credibility, and authority to handle each account from lead generation through contract execution + Provide leadership and… more
    Cardinal Health (08/23/24)
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  • Provider Contract/Cost of Care Analyst…

    Elevance Health (Atlanta, GA)
    …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Anticipated End Date:** 2024-09-13 **Position Title:** Provider Contract/Cost of Care Analyst Senior **Job Description:** **Provider Contract/Cost of Care more
    Elevance Health (09/06/24)
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  • Value Based Contract / Cost of Care

    Elevance Health (Atlanta, GA)
    …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... 2024-09-13 **Position Title:** Value Based Contract / Cost of Care Consultant **Job Description:** **Value Based Contract / Cost...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (09/06/24)
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  • Provider Contract/Cost of Care Consultant

    Elevance Health (Atlanta, GA)
    …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Anticipated End Date:** 2024-10-07 **Position Title:** Provider Contract/Cost of Care Consultant **Job Description:** **Provider Contract/Cost of Care more
    Elevance Health (09/07/24)
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  • Capture Lead , Medicaid Clinical…

    Humana (Atlanta, GA)
    …ability of limited resources to achieve growth. Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions ... health first** Humana Healthy Horizons is seeking a Capture Lead , Clinical & Population Health Strategy, to lead...achievement. + 5+ years of experience in a Medicaid Managed Care Organization (MCO) focusing on Medicaid… more
    Humana (08/15/24)
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  • Nurse Medical Management Sr

    Elevance Health (Atlanta, GA)
    …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... ( Must work EST) **Responsible to serves as team lead for nursing staff who collaborate with healthcare providers... clinical experience or case management, utilization management or managed care experience; or any combination of… more
    Elevance Health (09/06/24)
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  • Key Account Manager, Hematology, Heartland

    Takeda Pharmaceuticals (Atlanta, GA)
    …level. + Appropriately uses available tools and resources to monitor and evaluate industry/ managed care trends and communicate relevant information to those who ... are impacted (ie Sales Forces, Leadership, and Managed Care Accounts). + Works within established...ideas. + Proactively shares customer insights to matrix, team, leader , and marketing to ensure customer needs are met.… more
    Takeda Pharmaceuticals (07/19/24)
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  • Medical Director - Gulf South

    Humana (Atlanta, GA)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (09/06/24)
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  • Medical Director - Southeast Region

    Humana (Atlanta, GA)
    …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (08/20/24)
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  • Behavioral Health Medical Director - Medicare

    Humana (Atlanta, GA)
    …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments… more
    Humana (08/07/24)
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  • Medical Director - Mid West Region

    Humana (Atlanta, GA)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
    Humana (08/27/24)
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  • Medical Director - Acute Inpatient Rehabilitation

    Humana (Atlanta, GA)
    …management, and acute inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... judgement to make determinations whether requested services, requested level of care , and/or requested site of service should meet authorization requirements. All… more
    Humana (08/27/24)
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  • Sr Director, Value Based Pricing - Preferably…

    Prime Therapeutics (Atlanta, GA)
    …**Responsibilities** + Knowledge of and experience with Medicaid pharmacy practice, managed care pharmacy practice, and/or pharmaceutical rebate contracting. + ... + Doctor of Pharmacy (PharmD) required. + 10+ years' professional experience in managed care and/or Medicaid. + 5+ years' experience in account management… more
    Prime Therapeutics (07/22/24)
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  • Market Chief Medical Officer (must reside in GA)

    AmeriHealth Caritas (Atlanta, GA)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... by plan; support regulator quality initiatives. + Credentialing Committee lead maintaining quality of care standards by...of medical management and general management experience in a managed care environment is required. + Proficiency… more
    AmeriHealth Caritas (06/28/24)
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  • RN Transplant Case Manager II (Telephonic)

    Elevance Health (Atlanta, GA)
    …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... to interpret and apply member contracts, member benefits, and managed care products preferred. + Certification as...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (09/06/24)
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  • Telephonic Nurse Case Manager I

    Elevance Health (Atlanta, GA)
    care setting preferred. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... **Telephonic Nurse Case Manager I** is responsible for performing care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (09/06/24)
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  • Manager, Clinic/Center Administration - CenterWell…

    CenterWell (Atlanta, GA)
    …**Preferred Qualifications** + Basic knowledge of Population Health Strategy + Medicare knowledge + Managed care experience + Value Based Care knowledge + ... TB. + Direct leadership experience and demonstrated ability to lead , coach and mentor teams + Proven interpersonal skills...of an interdisciplinary team + Solid understanding of medical care delivery, managed care financial… more
    CenterWell (07/31/24)
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  • Clinical Sales Specialist, (IBD) Atlanta South

    Takeda Pharmaceuticals (Atlanta, GA)
    …and adaptability to changing market conditions required + Demonstrated understanding of managed care landscape and how it influences/impacts business required + ... to demonstrate an excellence in developing and applying business processes that lead to achievement of sales goals and objectives. **How you will contribute:**… more
    Takeda Pharmaceuticals (09/07/24)
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