- HHS Technology Group, Inc. (Atlanta, GA)
- …makes a difference in the lives of people every day. HTG is a leader in the development and delivery of innovative, purpose-built modular software and technology ... stipulations. This highly valued Project Manager will oversee and lead the day-to-day activities of the project. This individual...a new system being built in which you project managed it from project kickoff to go-live. Project Management… more
- WTW (Atlanta, GA)
- …Wealth and Career and Risk and Broking. The Managed Care Growth Leader is the primary client lead managing the totality of the Willis Towers Watson ... (WTW) relationship for clients within the Managed Care Industry. This individual is accountable...business while managing existing revenue and profit streams + Lead the development and execution of client account plans… more
- Cardinal Health (Atlanta, GA)
- …strategic, business development, and contracting activities related to the Managed Care environment. They will be a seasoned leader and advisor, with ... team is passionate about helping oncology practices navigate the future. The Director, Managed Care is responsible for strategy and management of managed… more
- Cardinal Health (Atlanta, GA)
- …to the National VP of Sales, the Director, Sales & Business Development - Managed Care is an individual contributor, executive sales position. This individual ... at decision-makers and decision influencers at existing and new managed care accounts. This individual must be...skills, credibility, and authority to handle each account from lead generation through contract execution + Provide leadership and… more
- Elevance Health (Atlanta, GA)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Provider Contract/Cost of Care Analyst Senior-Analytics** **Location:** This position will work...team** is looking for a senior analyst who will lead medical cost trend deep dives to uncover root-cause… more
- Elevance Health (Atlanta, GA)
- …or related field; minimum of 5 years' experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Provider Contract Cost of Care Consultant** **Location** : This position will work...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Atlanta, GA)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Value Based Contract / Cost of Care Consultant** The **Value Based Contract / Cost...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Humana (Atlanta, GA)
- …ability of limited resources to achieve growth. Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions ... health first** Humana Healthy Horizons is seeking a Capture Lead , Clinical & Population Health Strategy, to lead...achievement. + 5+ years of experience in a Medicaid Managed Care Organization (MCO) focusing on Medicaid… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …level. + Appropriately uses available tools and resources to monitor and evaluate industry/ managed care trends and communicate relevant information to those who ... are impacted (ie Sales Forces, Leadership, and Managed Care Accounts). + Works within established...ideas. + Proactively shares customer insights to matrix, team, leader , and marketing to ensure customer needs are met.… more
- Humana (Atlanta, GA)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Atlanta, GA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Atlanta, GA)
- …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments… more
- Humana (Atlanta, GA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
- Humana (Atlanta, GA)
- …strategies and timeline based on analysis of internal and external source data and managed care program requirements. + Drives market competitor analysis and the ... strategy for its Medicaid growth markets. This strategist will lead data-driven research oriented strategic advisement in the development...evaluation of existing managed care requirements to assess gaps in… more
- Humana (Atlanta, GA)
- …management, and acute inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... judgement to make determinations whether requested services, requested level of care , and/or requested site of service should meet authorization requirements. All… more
- Humana (Atlanta, GA)
- …will be experienced health care strategists that possess broad Medicaid Managed Care expertise, deep working knowledge of insurance products, benefits, and ... for customer use. + Culture and Partnerships -Form and lead a high-performing team by recruiting top talent, fostering...or management consulting + Deep working knowledge of Medicaid managed care policy, programs and covered services… more
- Prime Therapeutics (Atlanta, GA)
- …**Responsibilities** + Knowledge of and experience with Medicaid pharmacy practice, managed care pharmacy practice, and/or pharmaceutical rebate contracting. + ... + Doctor of Pharmacy (PharmD) required. + 10+ years' professional experience in managed care and/or Medicaid. + 5+ years' experience in account management… more
- AmeriHealth Caritas (Atlanta, GA)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... by plan; support regulator quality initiatives. + Credentialing Committee lead maintaining quality of care standards by...of medical management and general management experience in a managed care environment is required. + Proficiency… more
- Elevance Health (Atlanta, GA)
- …care setting preferred. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... The **Telephonic Nurse Case Manager Senior** is responsible for care management within the scope of licensure for members...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Atlanta, GA)
- …the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, ... to interpret and apply member contracts, member benefits, and managed care products preferred. + Certification as...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more