- Molina Healthcare (Augusta, GA)
- **Job Description** **Job Summary** Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements ... initiatives to improve Star Ratings. * Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet… more
- CVS Health (Atlanta, GA)
- …largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr . Manager provides technical, analytical and business support for the FEP Account ... team. The role serves as the authority for FEP program data analytics, trend analysis, contractual guaranteed financial metrics,...the Medicare Business Analytics - FEP - Sr . Manager incorporates these into all aspects… more
- Gilead Sciences, Inc. (Atlanta, GA)
- …that will improve the lives of patients with life-threatening illnesses worldwide. The ** Sr .** **Field Reimbursement Manager - HIV Prevention (** ** Sr . ... in navigating the complexities of the healthcare system. The Sr . FRM HIV Prevention will provide in-person and virtual...and reimbursement outcomes. + Assist the internal patient support program team in enhancing hub and FRM processes, such… more
- Elevance Health (Columbus, GA)
- …Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** Waystar is seeking a smart and creative Senior Product Manager with hands on experience in Healthcare Revenue Cycle Management. We are ... closely with User Experience team and Technology teams. The Senior Product Manager will lead cross departmental...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Elevance Health (Atlanta, GA)
- **JR127299 Business Consultant Sr (Analytical)** The Sr . Business Consultant will support the Advanced Primary Care risk adjustment team through vendor ... **How will you make an impact:** + Partner with Program Director on end-to-end management of retrospective coding ...risk adjustment and/or health insurance industry. + Experience in Medicare Advantage and Medicaid in a provider based or… more
- Cardinal Health (Atlanta, GA)
- …receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **_Responsibilities_** The Case ... Manager supports patient access to therapy through Reimbursement Support...therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is… more
- Prime Therapeutics (Atlanta, GA)
- …and drives every decision we make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior Contract Representative is ... years of comprehensive experience working with Rebate contracts, or within Medicare /Medicaid (eg insurance, government program operations, managed care… more
- CVS Health (Atlanta, GA)
- …high-performing actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage and Prescription Drug Plan business. This position will ... scenario testing, supporting model development and maintenance, and working with manager , peers, and business partners to develop simple explanations for drivers… more
- Molina Healthcare (Augusta, GA)
- **Knowledge/Skills/Abilities** * Responsible for program development, implementation, and management of process improvement initiatives. * Coordinates, directs, and ... Conduct meetings and disseminates communication related to process improvement activities to senior leadership and staff as needed. * Knowledge of HEDIS measurement… more
- CVS Health (Atlanta, GA)
- …within network as well as other business areas (clinical, operations, Medicare segment). **Required Qualifications** + Successful project management experience in ... increasingly more complex projects across a highly-matrixed organization + Project/ program expertise in stakeholder facilitation, communications and relationship management… more
- Prime Therapeutics (Atlanta, GA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Clinical Program Manager - Remote **Job Description** The Clinical Program ... and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations...Structure** + Reports to Sr Principal or Sr Director in the Clinical Program Management… more
- Prime Therapeutics (Atlanta, GA)
- …vision, depth perception and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
- Cardinal Health (Atlanta, GA)
- …+ Pharmacy benefits management experience preferred with specific knowledge of Medicare , Medicaid and commercially insured payer common practices and policies, ... and internal customers, create and complete applications for enrollment within program timeframes, review forms and supporting documentation thoroughly for any… more
- CenterWell (Atlanta, GA)
- …part of our caring community and help us put health first** The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health ... outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the… more
- Humana (Atlanta, GA)
- …help us put health first** Humana's Marketing organization is seeking a Senior Business Intelligence Engineer, Measurement Strategy & Marketing Performance to join ... market trends, and campaign performance. **Key Role Functions** + Works with Campaign Manager and Campaign Strategy roles to define the measurement approach for each… more
- Molina Healthcare (GA)
- …Clinical Systems, Medical Economics, Market Engagement, etc. to ensure efficient and effective program delivery + Package material for senior leaders, up to and ... Economics and Finance teams, drive, plan and manage a comprehensive program focused on identifying, defining, designing, implementing and tracking performance for… more
- MarketSource (Alpharetta, GA)
- …and lead the insurance compliance management strategy for the organization's Medicare Advantage sales program including carrier compliance, and multi-carrier ... 121666BRTitle:Compliance ManagerJob Description: Compliance Manager (Insurance) MarketSource Inc., an Allegis Group Company, develops and delivers innovative managed… more
- Humana (Atlanta, GA)
- …the role for you. We are seeking a dynamic and experienced Lead Product Manager to lead our self-service and support product line encompassing both services and ... and other product teams as needed. A successful product manager is highly analytical, able to work effectively in...the success of solutions pursued. + Interact directly with senior management to advise on and obtain input for… more
- Gentiva (Alpharetta, GA)
- …to join our team.You will report directly to the Executive Director, Administrator, or Senior Patient Care Manager . You will be responsible for maintaining a ... high performing hospice program including managing, overseeing, and directing patient care activities to ensure the delivery of quality patient care. This role is… more