- Elevance Health (Columbus, 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 ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Molina Healthcare (Columbus, GA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Elevance Health (Columbus, GA)
- ** Director I Care Consultant** **Location:** This position will work a hybrid model (remote and office). Must reside within 50 miles/1 hour commute of our Atlanta or ... Columbus, GA, Elevance Health locations. The ** Director I Care Consultant** is responsible for strategy and implementation of Provider Success programs in the state… more
- Molina Healthcare (Columbus, GA)
- …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-10 CPT-4,… more
- Molina Healthcare (Columbus, GA)
- …therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics ... + Provides medication therapy management including examination of member medical records, performing a comprehensive medication review, and communicating with… more