- Ryder System (Atlanta, GA)
- …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… 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 ... and product quality + Assisting your VP of Product Management in coordinating with sales, marketing, development, and customer...+ bonus, if applicable) + Customizable benefits package (3 medical plans with Health Saving Account company match) +… more
- CVS Health (Atlanta, GA)
- …during the plan year. The **Medicare** **Benefits Standards & Guidance Lead Director ** ensures accountability for the implementation, management , and maintenance ... Employer Groups. The **Medicare** **Benefits Standards & Guidance Lead Director ** acts as the point of contact to our...such as Benefit & Product Strategy, Benefits & Product claims configuration, Medicare Service Operations (MSO), Medical … 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 ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… 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)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Molina Healthcare (Atlanta, GA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Aveanna Healthcare (Duluth, GA)
- …to the Governing Body, also reporting to Area Vice President, AVP, and/or Area Director , AD. Essential Job Functions Team Management : * Assure evaluation of each ... Hospice RN Executive Director ApplyRefer a FriendBack Job Details Requisition #:...client satisfaction survey report on client served * Incident Management /Issue Resolution Business Operations: * Plan and implement branch… more
- EPAM Systems (Atlanta, GA)
- …driving strategic and operational excellence across client functions such as underwriting, claims and distribution management . You will contribute to the ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more
- The Cigna Group (Atlanta, GA)
- …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical ... **LOCATION:** **Must live in Atlanta, GA area** The ** Director , Provider Contracting** serves as an integral member...This role assists in developing the strategic direction and management of the day to day contracting and network… more
- Prime Therapeutics (Atlanta, GA)
- …our passion and drives every decision we make. **Job Posting Title** Senior Director of Underwriting - REMOTE **Job Description** The Sr. Director Underwriting ... for prospective clients and new customer acquisitions. **Responsibilities** + Analyze claims data and develop cost-of-care projections for existing customer renewals… more
- EFI Global (Atlanta, GA)
- …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... to learn more about EFI Global. **We are seeking a Client Services Director with experience in the insurance industry, specifically in executive general adjusting… more
- Molina Healthcare (Atlanta, GA)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... from root cause analysis through implementation * Oversees vendor FWA case management including tracking on schemes, coordinating internal efforts with vendor to… more
- Trustmark (Atlanta, GA)
- …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… 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
- Stantec (Atlanta, GA)
- …and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. + Sound knowledge and experience ... context of the communities we serve, we provide planning, engineering, and infrastructure management services that fit the needs of our clients and improve the… more
- Molina Healthcare (Atlanta, GA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * In conjunction with the … more
- UMB Bank (Atlanta, GA)
- …across all payment channels. Will work with the Enterprise Fraud Prevention and Claims teams to provide data to help identify emerging fraud trends and UMB's ... concert with the Enterprise Fraud Prevention and Enterprise Fraud Claims teams to identify fraud exposure and make necessary...to fulfill overall business needs and expectations of the Director of Enterprise Fraud Operations and the bank's senior… more
- Cardinal Health (Atlanta, GA)
- …on policies. **_Manager, Ethics and Compliance_** Reporting to the Compliance Director , this position is responsible for supporting the programmatic requirements for ... focus include: compliance training, policy development, exclusion screening tracking, management of investigations and development of programmatic presentation materials.… more
- United Musculoskeletal Partners (Suwanee, GA)
- **DESCRIPTION** **Description** + Provide on-site management of the Resurgens Orthopaedics Durable Medical Equipment ("DME") Program. + Under the direct ... level of customer service to patients and their family members, physicians, clinic management , and all other employees. + Assist with education of clinical employees… more