- Elevance Health (Atlanta, GA)
- …deliver member-centered, lasting pharmacy care. In this pivotal role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account Director ... preserving and deepening relationships with clients which include Elevance Health Medicare Health Plans. This position, structured around geographic regions and… more
- Elevance Health (Atlanta, GA)
- ** Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will **must live** within 50 miles of one ... of our Elevance Health PulsePoint locations. The ** Medicare Medical Director ** is responsible for the...consultation and serve as clinical/strategic advisor to enhance clinical operations . May identify cost of care opportunities. May serve… more
- Elevance Health (Atlanta, GA)
- …objectives. + Collaborates with management to set strategic vision; oversees manager(s)/ director (s) with direct reports. + Hires, trains, coaches, counsels, and ... **Preferred Skills, Capabilities and Experiences** + Knowledge and understanding of Medicare rules and regulations for program areas including but not limited… more
- The Cigna Group (Atlanta, GA)
- …Provider Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director , this individual ensures the effective ... collaborative organization (which includes Market Provider Performance, Sales, Clinical Operations , Stars & Risk Adjustment, Finance , Cross-Segment Contracting,… more
- CVS Health (Atlanta, GA)
- …make health care more personal, convenient and affordable. **Position Summary:** **The Lead Director , Operations (hiring for two positions)** plays a key role by ... in health care analysis methods and tools, clinical performance improvement, clinical operations in a care delivery setting, population health and care management +… more
- CenterWell (Stone Mountain, GA)
- …of our caring community and help us put health first** The Associate Medical Director serves as a health-care professional and capable of handling a variety of ... health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities...state of desired employment + Experience leading clinical practice operations . + Demonstrate a high level of skill with… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Director , Provider Contracting, leads and manages the provider networks for all of Humana's various ... lines of business through the NC Contracting team. The Director also initiates, analyzes, and negotiates hospital, physician, and/or other provider contracts and… more
- Robert Half Legal (Alpharetta, GA)
- …(CRCM) to enhance compliance processes. * Leverage expertise in Health Care Audits - Medicare - Medicaid to improve operations and compliance. * Utilize strong ... This role will primarily focus on healthcare Medicaid HIPAA compliance. The Director of Program Integrity will be responsible for managing compliance functions,… more
- Brookdale Senior Living (Atlanta, GA)
- …communities. Actively partners with Training and Development, Human Resources, and Operations in the recruitment, hiring, evaluating, and disciplining of all sales ... on a scheduled basis and as approved by Division Director of Sales or VP Sales. Partners with on-site...achieve and maintain full occupancy. + Interacts with Clinical Operations and other home office associates. Educates and supports… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Ongoing mentorship and leadership programs + And more **Description** **The Director , Pharmacy Services** is responsible for the strategic planning, design, ... operations , and improvement of the medication management system to...and Drug Administration, US Drug Enforcement Administration, Centers for Medicare and Medicaid statutes and regulations, and the Georgia… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Center (ETC) and its programs remain compliant with Centers for Medicare and Medicaid Services (CMS), Organ Procurement and Transplantation Network (OPTN)/United ... regulatory changes and communicates any new requirement concerns to ETCs Executive Director (s) and Sr. Vice President. + Collaborates with ETC and program leadership… more
- Gilead Sciences, Inc. (Atlanta, GA)
- …the lives of patients with life-threatening illnesses worldwide. As the **Senior Director , Field Reimbursement Management (FRM)** for HIV Prevention, you will play a ... This position will drive the Field Reimbursement team's strategic direction, operations , and performance to optimize patient access and navigate complex insurance… more
- Waystar (Atlanta, GA)
- …The Procurement Director will direct the procurement strategy and operations for Waystar, focusing on optimizing supplier relationships, managing costs, and ... hospitals and health systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out our organizational values:… 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 ... plans. + 8+ years of experience in the PBM domain (Commercial/Medicaid/ Medicare ) including claims processing, enrollment, and benefit administration. + Experience… more
- Prime Therapeutics (Atlanta, GA)
- …the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance + Develop ... and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate findings as… more
- CenterWell (Stockbridge, GA)
- …and objectively, in consultation with the Human Resources Department and the Executive Director / Director of Operations . + Participates in the interviewing, ... on both home health clinical quality assurance and home health clinical operations initiatives. + Develops, plans, implements, analyzes, and organizes clinical … more
- Prime Therapeutics (Atlanta, GA)
- …and ability to adjust focus **Reporting Structure** + Reports to a manager or director in the Clinical Operations , Contact Center, Network Management or PBM ... processes, and participates in committee review meetings within the Commercial, Medicare , Medicaid, and Health Insurance Marketplace for the assigned department.… more
- Prime Therapeutics (Atlanta, GA)
- …in assigned function to ensure organizational obligations are met and business operations are aligned with applicable laws and regulatory guidance. + Provide ... or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +...ability to adjust focus **Reporting Structure** + Reports a Director in the Compliance department Potential pay for this… more
- Aveanna (Atlanta, GA)
- …is a remote position. Position Overview Under direct supervision of the Sr. Director , IT Operations and Logistics, responsible for overseeing and managing all ... of each workday. Vaccination Requirements As an employer accepting Medicare and Medicaid funds, employees must comply with all...a signed agreement with Aveanna. As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** This role reports to a Director , Product Management and work closely with User Experience team and Technology teams. The Product Manager will ... coordinate with key stakeholders in sales, marketing, design, development, and operations . This role will be charged with leading game changing efforts at Waystar… more