- HomeSafe Alliance (Atlanta, GA)
- …and motivated Assistant Claims Manager to assist in all aspects of claims management , to support and promote process improvement methodologies and best ... Raising awareness of any settlement practices, trends, or areas of concern to the Director of Claims . Responds to internal and external customer disputes and… more
- Humana (Atlanta, GA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Atlanta, GA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- CVS Health (Atlanta, GA)
- …clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to ... and appeal system. + Leads the administration of all medical management activities of the aligned Plans....the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- Humana (Atlanta, GA)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director reviews cases of diverse scope and complexity ranging...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical /surgical utilization management review experience + Experience… more
- Norstella (Atlanta, GA)
- …will be pivotal in integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health ... Senior Director , RWD Analytics and Innovation Company: Citeline Location:...of data and intelligence on clinical trials, drug treatments, medical devices and what's new in the regulatory and… more
- J&J Family of Companies (Atlanta, GA)
- Director , Health Economics and Market Access - Robotics and Interventional Solutions - 2406204289W **Description** Johnson & Johnson is recruiting a Director , ... and profoundly impact health for humanity. Learn more at https://www.jnj.com/. The Director , Health Economics & Market Access for the Robotics and Interventional… more
- Elevance Health (Atlanta, GA)
- **Anticipated End Date:** 2024-09-09 **Position Title:** Associate Research Director **Job Description:** **Associate Research Director ** **Location:** This ... in support of a wide variety of healthcare decisions. The **Associate Research Director ** will be responsible for overseeing a series of projects assigned to them… more
- Boehringer Ingelheim (Colbert, GA)
- **Description** The role of Director , Georgia Clinical R&D Center is a key position within the Clinical Site Network organization of Animal Health (AH), responsible ... the Clinical Site Network and the other Global Clinical Functions, the Director , Georgia Clinical R&D Center oversees clinical development for assigned projects and… more
- Axis (Alpharetta, GA)
- …upon request for candidates taking part in the selection process. Director , Product Development Job Family Grouping: Operations Job Family: Product Development ... filed and issued pursuant to approved state filings and with AXIS Product Management team to develop form requirements for implementation in AXIS's policy issuance… more
- EPAM Systems (Atlanta, GA)
- …- Payor, Provider, or Life Sciences and/or horizontal areas - Core Operations: Claims , Enrollment and Billing, Med Management ; RCM; Commercial Operations, Supply ... sounds like you, this could be the perfect opportunity to join EPAM as a ** Director , Healthcare Advisory** . In this role, you will engage with insurance clients in… more
- Cardinal Health (Atlanta, GA)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Sedgwick (Atlanta, GA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Global Accounts Payable **PRIMARY PURPOSE OF THE ROLE:** The Global ... Director of Accounts Payable is responsible for leading the...across the AP team through training, coaching and performance management . + Continually evaluates processes, systems for improvement. +… more
- Evolent Health (Atlanta, GA)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Norstella (Atlanta, GA)
- Director , RWD Product Company: MMIT Location: Remote, United States Date Posted: Jul 15, 2024 Employment Type: Full Time Job ID: R-440 **Description** Why Norstella? ... assess market potential, and inform strategic decision-making. + Translate product management strategy into actionable data deliverables, guiding development of data… more
- Evolent Health (Atlanta, GA)
- …LPCs, and Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Associate Director and Director ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Mass Markets (Savannah, GA)
- …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... - POSITION RESPONSIBILITIES This role is responsible for the management and development of supervisors and all other operational...all employees are eligible to opt for our MEC medical plan after only 30-days of employment. Benefits options… more
- Federal Reserve Bank (Atlanta, GA)
- …to influence work. + You have the knowledge and expertise to own outcomes of medical case management . You work with independence and sound judgement to ensure ... to do work that touches lives and helps communities prosper. The Senior Medical Leave and Support Services Specialist administers the Bank's policies and procedures… more
- State of Georgia (Fulton County, GA)
- …additional experience in the analysis of medical services documentation and related claims 2) Utilization Review 3) Case Management 4) Analysis of CPT codes ... Job Summary Under the direction of the Fraud Unit Director , assists in healthcare investigations by: reviewing provider and...clinical experience AND one (1) year experience working with medical claims . Preference will be given to… more