- Elevance Health (Atlanta, GA)
- …volume of provider. + Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical charts, medical notes, itemized ... provider contracts. + Conducts exit interview with provider management team by presenting preliminary review results. + Verifies dollar...+ Verifies dollar amount on claim is correct in claims system and writes report of the findings of… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …positioning. **Key Responsibilities** + **Brand Strategy & Lifecycle Management:** Lead marketing for established brands like Nuedexta, ensuring strategic ... resource allocation. + **Portfolio Planning:** As needed, support the team with relevant early commercialization work and planning within...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Prime Therapeutics (Atlanta, GA)
- …of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation and analytic insight ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Molina Healthcare (Columbus, GA)
- …across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice, ... Medicaid, Medicare, and Marketplace populations. + Collaborate with legal, claims , provider relations, finance, and compliance departments to ensure coordination… more
- Molina Healthcare (Augusta, GA)
- …Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
- Amentum (Atlanta, GA)
- …and recommend appropriate insurance coverage and risk mitigation strategies. + Lead complex claims management, including litigation strategy and resolution ... in approximately 80 countries across all 7 continents. The Amentum Risk Management Team has an immediate opening for a **Director of Insurance and Risk Management**… more
- CVS Health (Atlanta, GA)
- …and deliver outstanding customer service. You will work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not ... looking for ways to further automate reporting activities. New team members are onboarded with training in this niche...timely manner so as not to impact delivery + Lead by example to inspire a positive attitude, engagement,… more
- Legacy Parking Company (Atlanta, GA)
- …programs and initiatives that may arise from the operation of assigned location(s) + Lead , direct and develop team of employees to accomplish annual and periodic ... Team Leaders + Monitor and review all damage claims . Recommend and implement plans or programs to improve...a plus + Must have demonstrated the capacity to lead and both anticipate & solve problems + Demonstrated… more
- Elevance Health (Atlanta, GA)
- …+ Complex data mining analysis and coordinating the activities of a project team experience highly preferred. + Claims analysis experience highly preferred + ... Consultant** is responsible for collaborating with our data science team to develop machine learning models and data mining...savings. **How you will make an Impact:** + May lead teams of analysts assigned to complex projects. +… more
- Zurich NA (Atlanta, GA)
- …approval of terms and conditions + Partner with Product Development and Technical Underwriting team to monitor product to ensure that products are fit for purpose + ... Lead and/or support cross functional projects that support the...the Middle Market portfolio. + Partner with the actuarial team to monitor Model Price accuracy, develop and implement… more