• Claims Research & Resolution Lead

    Humana (Atlanta, GA)
    …efforts 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** Humana Healthy Horizons in Oklahoma is seeking a Claims Research & Resolution Lead to lead a team that focuses on supporting providers in… more
    Humana (03/22/25)
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  • Senior Compliance Analyst (Interpretation…

    Prime Therapeutics (Atlanta, GA)
    …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
    Prime Therapeutics (03/04/25)
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  • Senior Data Engineer

    Humana (Atlanta, GA)
    …help us put health first** Humana Healthcare Research (HHR), a health outcomes research subsidiary of Humana, is seeking a Senior Data Engineer to design, ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… more
    Humana (03/20/25)
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  • Senior Behavioral Economics Professional

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... part of our caring community and help us put health first** The Senior Behavioral Economics Professional (SBEP) is a core member of Humana's industry-leading… more
    Humana (03/20/25)
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  • Senior Data Scientist

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... of healthcare through AI excellence. We are seeking a Senior Data Scientist to develop reliable, interpretable, and steerable...+ Master's Degree and 3+ years of experience in research /ML engineering or an applied research scientist… more
    Humana (01/28/25)
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  • Sr. Professional Network Strategy

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Senior Professional Provider Network Strategy will be accountable for supporting the development of… more
    Humana (03/06/25)
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  • Associate Actuary

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... first** The Associate Actuary, Analytics/Forecasting applies statistical/actuarial methods to advise senior leadership and other business stakeholders on matters of … more
    Humana (02/19/25)
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  • Sr Business Project Manager

    Humana (Atlanta, GA)
    …a managed care healthcare system or health plan. + Experience working in Medicaid and/or Medicare . **Preferred Qualifications** + 3+ years of leadership ... processes. + Proficiency in Microsoft Office programs. + Experience working in Medicaid / Medicare implementation. + Prosci, Six Sigma, and/or Project Management… more
    Humana (03/09/25)
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  • Director, Product Management- eCommerce

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... can be used to drive customer acquisition in the Medicare Advantage space. Within this business area, we are...on approaches to best-practices in Product Management. Be a senior leader in how Product Management at the company… more
    Humana (03/22/25)
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  • Director, Competitive Intelligence, Stars

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... ideal candidate will possess a deep understanding of the Medicare landscape, strong analytical skills and the ability to...leadership team + Collaborate with Stars Measure Owners and senior leaders to refine strategies that align our mission,… more
    Humana (03/04/25)
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  • Field Medical Director, Cardiology

    Evolent (Atlanta, GA)
    …in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... for utilization management while working in conjunction with the Senior Medical Director. **Qualifications - Required and Preferred:** +...by any state or federal health care program, including Medicare or Medicaid , and is not identified… more
    Evolent (02/14/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Atlanta, GA)
    …in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... for utilization management while working in conjunction with the Senior Medical Director. **Qualifications** + MD/DO/MBBS Degree + Current,...by any state or federal health care program, including Medicare or Medicaid , and is not identified… more
    Evolent (01/30/25)
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  • Associate Director, CenterWell Digital Design

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... product partners, and Integrated Health. + Guide and mentor UI, UX, research , and content professionals in best practices. + Foster collaboration between design… more
    Humana (03/21/25)
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  • Sr. Product Manager

    Waystar (Atlanta, GA)
    …1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid / Medicare payers. We are deeply committed to living out our organizational ... **ABOUT THIS POSITION** Waystar is seeking a smart and creative Senior Product Manager with hands on experience in Healthcare Revenue Cycle Management. We are… more
    Waystar (03/17/25)
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  • Field Medical Director, Radiology (Pulmonology…

    Evolent (Atlanta, GA)
    …is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... exclusion or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by the Office of… more
    Evolent (03/21/25)
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  • Interoperability Strategy Lead

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... Strategy Lead, you will deconstruct issues and challenges, perform targeted research and analysis, and craft sound, logical solutions and recommendations. You… more
    Humana (03/22/25)
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  • Performance Marketing Intern

    Waystar (Atlanta, GA)
    …1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid / Medicare payers. We are deeply committed to living out our organizational ... of a comprehensive marketing campaign including the pre-planning and research the goes into it + Learn about industry...NEED** **Do you fit our team?** + Junior or Senior + 3.2 or above GPA + Actively involved… more
    Waystar (01/25/25)
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  • Sr Data Scientist, People Analytics

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... infrastructure, innovative analytic product development, and cutting-edge data science capabilities. The Senior Data Scientist will be a key member of the People… more
    Humana (03/21/25)
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  • Value Based Programs Specialty Care Lead

    Humana (Atlanta, GA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... improve quality and the member experience + Works with senior executives and various program owners to develop and...the requisition number so we may be able to research your request quicker. \#LI-LM1 **Scheduled Weekly Hours** 40… more
    Humana (03/15/25)
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  • Associate Medical Director, Cardiology

    Evolent (Atlanta, GA)
    …exclusions, sanctions, or disciplinary actions by **state or federal healthcare programs ( Medicare , Medicaid , OIG, or GSA).** Join us at **Evolent Health** ... Collaborate with cross-functional teams, including **clinical reviewers, management, and senior leadership,** to improve decision-making and care outcomes. + Assist… more
    Evolent (03/04/25)
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