• Director, Quality External Programs

    Emory Healthcare/Emory University (Atlanta, GA)
    …embed quality priorities into system strategy and daily practice + ** CMS Quality Program Leadership** + Provide strategic oversight for CMS ... + Monitor system performance on CMS star ratings, quality measures, and pay-for-performance programs + Partner with clinical and operational… more
    Emory Healthcare/Emory University (10/02/25)
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  • Risk & Quality Performance Manager

    Molina Healthcare (GA)
    …EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of ... Plan Risk and Quality leaders to improve outcomes by managing Risk/ Quality data collection strategy , analytics, and reporting, including but not limited… more
    Molina Healthcare (10/13/25)
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  • National Medical Director, Home-Based Care…

    CenterWell (Atlanta, GA)
    …and Outcomes Management ** + Develop and oversee robust clinical quality evaluation frameworks to monitor program outcomes, adherence to benchmarks, ... the highest-need and most complex senior patients. This role will lead clinical strategy , quality improvement, and care delivery innovation for chronically and… more
    CenterWell (10/02/25)
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  • Medicaid Data Strategy Consultant

    Guidehouse (Atlanta, GA)
    …documents, and traceability matrices), ensuring completeness, consistency, and alignment with Medicaid program needs. + Participate in MMIS system design reviews ... **Job Family** **:** Strategy & Transformation Consulting **Travel Required** **:** Up...documented actionable insights for diverse stakeholders ranging from Medicaid program staff to system vendors and internal… more
    Guidehouse (09/27/25)
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  • Manager, Software Engineering - ML Products

    Warner Bros. Discovery (Atlanta, GA)
    …to our CMS You will collaborate effectively with product managers, program managers, designers and engineers across squads and teams to plan and execute ... of Planet Earth. Behind WBD's vast portfolio of iconic content and beloved brands, are the _storytellers_ bringing our...partners and stakeholders on activities such as planning, technical strategy , quality and delivery + Partner with… more
    Warner Bros. Discovery (07/26/25)
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  • Audit & Reimbursement Senior - Appeals

    Elevance Health (Atlanta, GA)
    …Skills, Capabilities and Experiences:** + Accounting degree preferred. + Knowledge of CMS program regulations and cost report format preferred. + Knowledge ... the Centers for Medicare and Medicaid Services to transform federal health programs ._ The **Audit and Reimbursement Senior** will support our Medicare Administrative… more
    Elevance Health (10/14/25)
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  • Medical Director, Behavioral Health (NE)

    Molina Healthcare (Augusta, GA)
    …and ability to learn new programs . Preferred Qualifications * Experience with utilization/ quality program management . * Managed care experience. * Peer ... health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job… more
    Molina Healthcare (10/03/25)
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  • Director, Marketing Communication Operations

    Humana (Atlanta, GA)
    …allocation across internal teams and external partners + Oversee vendor strategy , including selection, performance management , and contract negotiations aligned ... Sigma and/or PMP certification + Experience designing and implementing enterprise programs or transformation initiatives + Change management or transformation… more
    Humana (10/14/25)
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  • Healthcare Services Operations Support Auditor

    Molina Healthcare (Columbus, GA)
    …ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job ... and written communication skills. * Microsoft Office suite/applicable software program (s) proficiency. Preferred Qualifications * Utilization management , care… more
    Molina Healthcare (09/28/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Atlanta, GA)
    …clinical setting. + Experiencein Lean, Six Sigma, TQI, TQC or other quality management certification. + Experiencein health plan provider network performance ... that engage providers enrolled in the Organization's value-based reimbursement programs and continuous improvement models. The incumbent plays different potential… more
    Highmark Health (08/20/25)
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