- Humana (Atlanta, GA)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources which… more
- Humana (Atlanta, GA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources, which...and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director reviews cases of diverse scope and complexity ranging...and appropriateness of services rendered by healthcare professionals in compliance with CMS guidelines, clinical coverage criteria, and quality… more
- Humana (Atlanta, GA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
- Humana (Atlanta, GA)
- …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 ... requires an in-depth evaluation of variable factors. **Job Profile** The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Atlanta, GA)
- …**Additional Information** Typically reports to a Lead, may also report to a Regional/ Associate Vice President or Corporate Medical Director , depending on size ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- CenterWell (Savannah, GA)
- …of our caring community and help us put health first** The RN Branch Director is accountable for managing the day-to-day branch operations to ensure the following: ... operational efficiencies, quality of patient care, regulatory compliance , support of business development & patient base growth, achievement of key performance… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- CenterWell (Atlanta, GA)
- …a part of our caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety of medical records and ... and medical codes (eg, ICD-10-CM, CPT) to patient records. The Director , Medical Coding requires an in-depth understanding of how organization capabilities… more
- Humana (Atlanta, GA)
- …us put health first for our members, providers and ourselves. Desired Lead Associate to lead and manage the enterprise framework to facilitate and document ... work closely with established functions inside utilization management (Medical Director , clinician decision making teams, quality audits, prior authorization list… more
- CenterWell (Atlanta, GA)
- …expertise with the care team through daily huddles. + Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by ... 'on-call' program of CenterWell as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend...Medicine preferr + Active and unrestricted DEA license + Medicare Provider Number + Minimum of two to five… more
- CenterWell (Brunswick, GA)
- …of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- AdventHealth (Chatsworth, GA)
- …all the following duties and responsibilities in collaboration with the Department Director . These will include, but are not limited to: customer satisfaction, ... financial management, regulatory compliance , human resources issues, employee competency, performance improvement, maintaining and complying with policies and… more
- AdventHealth (Rome, GA)
- …content with learner engagement + Collaborates with the Clinical Education Market Director to review outcomes data to evaluate and refine competency management ... collaboration; initiates collaborative efforts ie, facility Chief Nursing Officer (CNO), Associate CNO and Nursing Directors + Considers and communicates impact of… more