- CVS Health (Atlanta, GA)
- …goals._** **Position Summary** This position will support the several parts of the Medicaid provider management team with focus on assignment, reporting, project ... on coordination and collaboration amongst of work for Network Operations-Intake and triage, provider data assignments, claim pend assignments. Will be lead for… more
- Humana (Atlanta, GA)
- …capable of providing frameworks to maximize available resources to achieve growth The Medicaid Senior Insurance Product Manager plays a critical role in ... the needs of Humana's customers while aligning with its business objectives. The ** Medicaid Senior Insurance Product Manager ** plays a critical role in… more
- Prime Therapeutics (Atlanta, GA)
- …our passion and drives every decision we make. **Job Posting Title** Contract Manager - NC Medicaid **Job Description Summary** Responsible for the ... and support of all activities related to developing and maintaining service provider contracts. Interacts with all areas of the Prime Therapeutics organization to… more
- Elevance Health (Atlanta, GA)
- …Health office locations. **Open to any Elevance Health office**_ The ** Provider Reimburse Admin** ensures accurate adjudication of claims, by translating medical ... policies, and editing rules, as well as conducts clinical research, data analysis, and identification of legislative mandates to support draft development… more
- CenterWell (Atlanta, GA)
- …part of our caring community and help us put health first** The senior product manager will play critical role in defining and executing Integrated Health data ... strategy and oversee the creation of trusted, cross-domain data assets that power the next generation of recommendation...that enhances omni channel patient experiences. The Senior Product Manager Leads all phases of the product life cycle,… more
- Humana (Atlanta, GA)
- …Science, Data Consulting, Data Visualization and Reporting. The Senior Data Manager acquires, cleans and develops datasets from internal and external ... cause analysis + Demonstrated ability to problem solve and provide solutions for business or data issues...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Vatica Health (Alpharetta, GA)
- …and quality against required standards. + Regularly consult with team members and the Manager of Clinical Training & Development to provide support and improve ... The Manager of Clinical Operations leads and manages the...Regularly assess and communicate the performance of staff members; provide ongoing feedback and coaching and work with Human… more
- HealthEdge Software Inc (Atlanta, GA)
- …functionality related toclaims adjudication,benefitsconfiguration,interfaces to third-partyclaims editors,and Provider data maintenance processes. You willdefine ... **Overview** **Position** **Overview:** As a Senior Product Manager , within theclaimsvalue stream forHealthRulesPayor, you will have ownership of system… more
- Humana (Atlanta, GA)
- …of our caring community and help us put health first** Join our team as a Data Visualization Engineer 2 and revolutionize how we interact with data ! As a pivotal ... member, you'll leverage cutting-edge tools and techniques to translate complex data into captivating visual stories. Harness your creativity to design intuitive… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** Waystar is seeking a smart and creative Product Manager with hands on experience in Healthcare Revenue Cycle Management. We are looking for ... work closely with User Experience team and Technology teams. The Product Manager will lead cross departmental strategic product initiatives coordinating with key… more
- Public Partnerships LLC (Alpharetta, GA)
- …care. Our role as the nation's largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and ... critical analysis of operational metrics to identify the root cause, and provide lean and quality-driven process and resource recommendations to upper management. +… more
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Manager - Remote **Job Description** The Pharmacy Network Manager is ... projects simultaneously + Demonstrated ability to problem solve and interpret complex data ; ability to analyze network information and synthesize it into meaningful… more
- Elevance Health (Atlanta, GA)
- …you will make an impact:** * Develops and analyzes business performance reports (eg claims data , provider data , utilization data ) used for month-end ... I** is responsible for collecting, analyzing, and reporting on data related to one or several but very similar...regulatory requirements, and other ad hoc submissions. * Prepares Medicaid provider state directed programs and other… more
- Elevance Health (Atlanta, GA)
- …supervisory review of work completed by other associates. + Analyze and interpret data per a provider 's trial balance, financial statements, financial documents, ... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit...but are not limited to: + Analyzes and interprets data and makes recommendations for change based on judgment… more
- Elevance Health (Atlanta, GA)
- …supervisory review on work completed by other associates. + Analyze and interpret data per a provider 's trial balance, financial statements, financial documents, ... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit...you will make an impact:** + Analyze and interprets data and makes recommendations for change based on their… more
- Elevance Health (Atlanta, GA)
- …supervisory review of work completed by other associates. + Analyze and interpret data per a provider 's trial balance, financial statements, financial documents, ... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit...you will make an impact:** + Analyzes and interprets data and makes recommendations for change based on judgment… more
- Elevance Health (Atlanta, GA)
- …brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to Medicaid plans in partnership with blue cross blue ... Psychiatrist who will be responsible for appeals reviews within our Medicaid and Medicare programs.** The **Behavioral Health Medical Director** is responsible… more
- Help at Home (Valdosta, GA)
- …consumer medical needs **Quality Assurance Related Functions:** + Review all forms, notify Case Manager of any incidents, and provide oversight for the follow up ... Revise PCP and ISP outcomes as necessary based on data collection, feedback from staff, and direct observation of...safety of the consumer, in a staffing crisis + Provide training and oversight for staff regarding Medicaid… more
- Elevance Health (Atlanta, GA)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Public Consulting Group (Atlanta, GA)
- …and client presentations + Plan, monitor, and manage ongoing tasks with the project manager + Provide guidance and support to project teams in subject matter ... reporting + Analyze and interpret federal and state law and regulations + Provide guidance related to cost allocation for public assistance programs including but… more