- Public Consulting Group (Atlanta, GA)
- …(CMS) and the new streamlined modular certification (SMC) and outcomes-based certification (OBC). Our ideal Medicaid Consultant will provide oversight ... changing, and PCG is at the forefront. We are looking for an experienced Medicaid Consultant to join our team and help lead our growth efforts. Deep Medicaid… more
- HealthEdge Software Inc (Atlanta, GA)
- **Overview** **Overview:** The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting ... products (from basic to advanced features/functionality), payment methodologies/policies (Medicare, Medicaid , and commercial), payment integrity, and healthcare plan operations… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- **Payment Integrity Consultant ** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, Georgia, Atlanta **Position ID:** ... (xweb.asp?clid=21001&page=cookiespolicy#integrationofyoutube) . **Position Description:** CGI is seeking Payment Integrity Consultant for our Emerging Technology team. As a Payment… more
- Public Consulting Group (Atlanta, GA)
- …carry out related project work across multiple public health care projects, including Medicaid programs + Serve as a subject matter expert in health care finance, ... benchmarking, financial management/analysis including experience projections, and administration + Medicaid actuarial experience (any state program, health insurer or… more
- Public Consulting Group (Atlanta, GA)
- …HCBS waivers such as 1915(c), 1915(i), 1915(j), and 1915(k), along with Medicaid State Plan benefits, PACE, SNFs, and ICF-IID. Knowledge must include federal ... creating or revising programs. + Experience partnering with the Centers for Medicare and Medicaid Services (CMS) for the approval of Medicaid benefits. + Strong… more
- Elevance Health (Atlanta, GA)
- …Amerigroup, is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services ... to Medicaid plans in partnership with blue cross blue shield...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- PruittHealth (Union City, GA)
- …needs and services including providing written explanation of Medicare, Medicaid and Insurance benefits to prospective patients/families when necessary, and ... Participates in ongoing inservice education. * Acts as a consultant to agency personnel. * Coordinates care provided to...in your field as well as to maintain current license/ certification , as required. * Attend and participate in mandatory… more
- Humana (Atlanta, GA)
- …two Agile transformations at large companies, and a current SAFe Practice Consultant (SPC) certification . Additional qualifications include one or more coaching ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Elevance Health (Atlanta, GA)
- …metrics to track performance and goal achievement + Serves as internal consultant relative to continuous improvement initiatives + Identifies and develops plans to ... **Preferred Skills, Capabilities and Experiences:** + Six Sigma Black Belt certification preferred. + Travels to worksite and other locations as necessary.… more
- Elevance Health (Atlanta, GA)
- …for company health plans including medical policies. + Serves as a resource and consultant to other areas of the company. + May interpret existing medical policy. + ... external committees. **Minimum Requirements:** + **Requires MD or DO and Board certification approved by one of the following certifying boards is required** ,… more