- Molina Healthcare (Columbus, GA)
- …and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality ... of the criteria for medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the… more
- Molina Healthcare (Macon, GA)
- … integrity framework * Strategizes with cross functional teams on payment integrity program advancements and best practice development * Responsible to engage ... years relevant experience in special investigation units, Insurance Fraud and Abuse, Payment Integrity Program , Law Enforcement or Risk Management * Minimum 8-10… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** This role reports to a Director , Product Management and work closely with User Experience team and Technology teams. The Product Manager will ... a team that designed, built, or used RCM Revenue Integrity products + Ability to interpret regulatory guidelines from...Ability to interpret regulatory guidelines from CMS, Tricare, and Medicaid websites + Ability to understand the vocabulary used… more