- Datavant (Atlanta, GA)
- …to deliver complex healthcare technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models (eg, ... experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the… more
- Humana (Atlanta, GA)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Atlanta, GA)
- …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, ... Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by members in an… more
- Humana (Atlanta, GA)
- …discussions with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Baylor Scott & White Health (Atlanta, GA)
- …Specialists, Payer Liaisons and Collectors focused on appealing hospital and professional clinical and coding denials, as well as Recovery Audit Contractors ... **Job Summary** The Director , Denial Resource Center is responsible for the...the strategic planning, evaluation, and operational oversight of the clinical denial management function for Baylor Scott and White… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- …domains, including pre-payment review, post-payment audit, FWA detection and prevention, coding accuracy, clinical integrity, and provider data management. * ... ** Director of Payment Integrity Consulting** **Category:** Finance **Main...including pre-payment review, post-payment audit, FWA detection and prevention, coding accuracy, clinical integrity, and provider data… more
- HCA Healthcare (Vidalia, GA)
- …care in 21 states and the United Kingdom. We are looking for a Director of Physician Services II for our South Atlantic Division, where excellence creates ... benefits may vary by location._** The role of the Director of Physician Services (DPS) is a strategic leader...strategic leader who oversees and takes ownership of a clinical operations market with less than 50 providers (DPS… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Emory's mission to serve humanity. We are currently seeking multiple Director 's of Development. The Woodruff Health Sciences Center (WHSC) Fundraising Department ... advances the Center's tripartite mission of education, research, and clinical care through integrated fundraising and engagement. The Department is comprised of six… more
- CenterWell (Atlanta, GA)
- …of our caring community and help us put health first** The Associate Director , Informatics coordinates with other analytics, IT and business areas across the ... organizational capabilities intersect within and across departments. The **Associate Director , Informatics** will be responsible for supporting Patient Safety… more
- CVS Health (Atlanta, GA)
- …And we do it all with heart, each and every day. The Lead Director , National VBC Performance Planning & Insights will act as a strategic leader driving ... actionable insights that guide business decisions for national and local providers. The Director will also play a key role in supporting the development and tracking… more