- Humana (Atlanta, GA)
- …caring community and help us put health first** Humana Healthy Horizons is seeking a Medicaid Implementation Senior Business Project Manager to manage a ... change management and project management are best suited for this role. The Medicaid Implementation Senior Business Project Manager will serve as a… more
- Prime Therapeutics (Atlanta, GA)
- … business (Employer Markets, Health Insurance Marketplace, Commercial, Medicare, Medicaid , Specialty) or with unique Prime contract requirements; drive the ... we make. **Job Posting Title** Health Plan Account Dir Sr - Remote **Job Description** The Sr ...advanced degree + Experience working within assigned line of business or market segment (Commercial, Medicare, Medicaid ,… more
- Humana (Atlanta, GA)
- …Medicaid products and capabilities to support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for ... Care Organization **OR** 2+ years of experience in strategy consulting supporting Medicaid managed care organizations. + Experience in business development or… more
- Public Consulting Group (Atlanta, GA)
- …and Grants Management + Assessments and Feasibility Studies PCG is looking for a Senior Consultant in Medicaid policy and funding as it relates to children's ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health,...children's behavioral health services. PCG is looking for a Senior Consultant in Medicaid policy and funding… more
- Prime Therapeutics (Atlanta, GA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Sr . Director, Pharmacy Network Management - Remote **Job Description** The Senior ... market leading pharmacy reimbursement methodologies that support all of Prime's business assuring coordination with performance standards and corporate goals. + Lead… more
- Humana (Atlanta, GA)
- …an in-depth evaluation of variable factors. The Senior Technology Implementation Professional gathers and documents business system and functional ... a part of our caring community and help us put health first** The Senior Technology Implementation Professional delivers new technological solutions to meet … more
- Humana (Atlanta, GA)
- …be responsible for meticulously reviewing regulatory changes and new rules pertinent to the Medicaid line of business . Your primary focus will be to identify ... requirements and assess potential impacts on various business areas. **Location:** remote The Senior Risk...reviewing regulatory changes and new rules pertinent to the Medicaid line of business . Your primary focus… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Senior Business Systems Analysis Professional who is part of the System Optimization ... ensuring optimal performance and integration across the procurement landscape. The Senior Business Systems Analysis Professional performs analyses of systems,… more
- Elevance Health (Atlanta, GA)
- …preferred. + Experience analyzing and building valued based care contracts for the Medicaid line of business preferred. + Experience reconciling value-based care ... **Provider Contract Analyst Senior ** **Location:** This position will work a hybrid...Experience working with claims and provider contracts for the Medicaid line of business preferred. Please be… more
- Humana (Atlanta, GA)
- …Coordinate business partner engagement with external regulators + Coordinate implementation and compliance with corrective action plans, as needed + Provide ... a part of our caring community and help us put health first** This Senior Compliance Professional role supports Humana's suite of Medicare and Commercial Dental and… more
- Deloitte (Atlanta, GA)
- …to make an immediate impact where you can help our clients solve their business challenges? Deloitte's Core Business Operations (CBO) portfolio operates at the ... center of our client's business . By joining our team, you could help C-suite...models, retooled program operations and industry-driven solutions. As a Senior Functional Lead on our Digital Health Team, you… more
- Humana (Atlanta, GA)
- …analyzes, plans and modifies network components supporting customer communication implementation activities. The Senior Network Engineer work assignments ... situations or data requires an in-depth evaluation of variable factors. The Senior Network Engineer will be responsible for providing engineering and operational… more
- HealthEdge Software Inc (Atlanta, GA)
- **Overview** **Position Overview:** We are seeking a Senior Payment Integrity Specialist to play a key role in building and implementing proprietary healthcare edits ... in claims processing. The successful candidate will be responsible for taking a senior level role in analyzing claims data, as well as translating contract terms,… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Service Fund Senior Value-Based Programs Analyst supports our Market and Provider partners through ensuring ... with the Market partners to ensure understanding and accuracy. The Senior Value-Based Programs Analyst work assignments involve moderately complex to complex… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Senior IT Product Owner (PO) role is responsible for managing and communicating the vision ... to the team to determine the HOW. The role drives value to the business by building and maintaining a product backlog in collaboration with stakeholder and delivery… more
- Elevance Health (Atlanta, GA)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program ... and implement varied projects, programs and plans that support the achievement of business unit and enterprise goals. The work here will be Test Program Management… more
- Prime Therapeutics (Atlanta, GA)
- …product domain and may align activities around a specific line of business (MedD, Medicaid , Health Insurance Marketplace, Commercial). **Responsibilities** + ... departmental strategy and new clinical product offerings (ie project representation across business units) + Represent the domain in partnership with key internal… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and its programs remain compliant with Centers for Medicare and Medicaid Services (CMS), Organ Procurement and Transplantation Network (OPTN)/United Network for ... any new requirement concerns to ETCs Executive Director(s) and Sr . Vice President. + Collaborates with ETC and program...issues. + collaboratively with ETC program leadership in effective implementation of UNOS policy changes and updates. + Takes… more
- Humana (Atlanta, GA)
- …experience. The individual in this role will lead Humana network infrastructure implementation for Google Cloud. The Lead Cloud Solutions Engineer (Network) performs ... to ensure an integrated architecture across interdependent technologies. Works with senior executives to develop and drive segment or enterprise-wide functional… more