- AIG (Atlanta, GA)
- Director of Claim Regulatory Compliance Who we are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 ... network. About the role The Director of Claim Regulatory Compliance will be...reasonable accommodation, please send an email to ###@aig.com . Functional Area: CP - Compliance AIG Claims ,… more
- United Therapeutics (Atlanta, GA)
- …and pulmonary diseases, and other orphan diseases. **How you'll contribute** The Senior Counsel, Regulatory & Compliance role is responsible for a broad range of ... legal, regulatory and compliance issues affecting the pharmaceutical...and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code,… more
- Humana (Atlanta, GA)
- …be authorized at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include ... 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
- Cardinal Health (Atlanta, GA)
- …insurance providers. + Maintain accurate employee benefits records and documentation. + Compliance and Regulatory Oversight: + Stay updated on all applicable ... and promote enrollment. **_Job Summary_** We are seeking an experienced and strategic Director of US Benefits to lead and oversee the design, implementation, and… more
- Humana (Atlanta, GA)
- …site of service should be authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which may include ... The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- Prime Therapeutics (Atlanta, GA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Director Account Management, PACE - Remote **Job Description** + Owns overall account ... Management Centers (CMC) and Shared Services, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis… more
- Molina Healthcare (Atlanta, GA)
- …all lines of business by promoting ethical practices and a commitment to compliance with applicable federal, state, and local laws, rules, regulations and internal ... data mining and data analysis, developing audit tools based on regulatory and contractual requirements, summarizing and approving investigations, resolving escalated… more
- Molina Healthcare (GA)
- …designs, setting procedural standards, and overseeing vendor operations to ensure compliance with key performance indicators (KPIs) and service level agreements ... business rules to Corporate Configuration for COB tables and Claims edits logic in the QNXT system as well...Payment Integrity Tracking databases. * Ensures CMS and state regulatory requirements are met, for Pre-pay Edits, Overpayment Recovery,… more
- TOCA USA (Atlanta, GA)
- …* Strive for Excellence * Create Awesome Experiences Job Highlights: Reports To: Sr. Director , People & Culture Location: MUST reside in Atlanta or Dallas (remote in ... such as benefits administration, leave of absence management, safety and compliance , compensation analysis, training and development and supporting the numerous… more
- Berry Global (Valdosta, GA)
- …information for weekly and monthly safety meetings. + Track training to ensure compliance with Corporate Regulatory Task Schedule. + Identify gaps in training ... of the Risk Assessment process.To direct activities relating to all regulatory agencies (OSHA, EPA, DOT, etc.), security, workers compensation and property/casualty… more
- Quality Technology Services, LLC (Atlanta, GA)
- …Provide strategic guidance on lease negotiations and customer interactions. + Facilitate compliance activities and conduct regulatory monitoring in support of ... The Economic Development Program Manager will work closely with the Director of Public Policy and Economic Development to facilitate interdepartmental teaming… more
- CVS Health (Atlanta, GA)
- …taking messages, researching information and assisting in solving problems. Adheres to Compliance with PM Policies and Regulatory Standards. Maintains accurate ... for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying… more
- PruittHealth (Norcross, GA)
- …service utilization meets needs for improved patient outcomes and appropriate claims reimbursement in accordance with regulatory billing guidelines. **KEY ... transfer (TSF) and discharge (D/C). + Ensure appropriateness, completeness, accuracy and compliance with all state and federal regulatory and accreditation… more