- CVS Health (Atlanta, GA)
- …suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting to the Lead Director of Medicaid Risk ... to identify areas of opportunity. + Produce and present dashboards specific to Medicaid Revenue Integrity efforts at various governance, market, and executive… more
- Molina Healthcare (Atlanta, GA)
- …and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality ... of the criteria for medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the… more
- CCSI INC (Atlanta, GA)
- …Service Boards Job Type Full-time Description POSITION/BUSINESS TITLE: Executive Director PROGRAM /DEPARTMENT: Georgia Association of Community Service Boards, ... Executive Director Atlanta, GA (http://maps.google.com/maps?q=Atlanta+GA+USA) * Georgia Association of Community… more
- Abt Global Inc. (Atlanta, GA)
- …with demonstrated success directing projects funded by the Centers for Medicare and Medicaid Services (CMS). As a member of the Research, Monitoring, and Evaluation ... leverage extensive experience in managing projects related to healthcare policy, program operations, and delivery; adeptly communicating with clients; and leading… more
- Molina Healthcare (Atlanta, GA)
- …Serves as a backup for the AVP of SIU in maintaining an effective payment integrity program for all lines of business by promoting ethical practices and a ... integrity framework * Strategizes with cross functional teams on payment integrity program advancements and best practice development * Responsible to engage… more
- Public Consulting Group (Atlanta, GA)
- …new opportunities, potential market shifts, and areas of risk. Liaise with Program Integrity regarding policy and compliance questions.Work with Client ... strategic clients + Understand and continually monitor Federal, state, and local Medicaid School-Based program policies and guidance, collaborating with PCG… more
- Public Consulting Group (Atlanta, GA)
- …in client management and project management, collaborating with Operations, Product, Program Integrity , and other staff to execute contractual obligations. ... may report to either a SBS COE Client Success Director or a Client Success Lead. **Duties and Responsibilities**...+ Understand and continually monitor Federal, state, and local Medicaid School-Based program policies + Leverage client… more