- Humana (Atlanta, GA)
- …to deliver agile, data-driven, and personalized member experiences at scale. As Director of Marketing Communication Operations, you will play a pivotal leadership ... approaches and compliance with CMS, Medicaid, and Pharmacy marketing standards ** Operational Excellence & Vendor Ecosystem** + Design and implement scalable… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Director , Clinical and Revenue Integrity Operations is responsible for the oversight and management of our team of Revenue Integrity ... to be an integral part of ongoing product and operational strategy. Technical and process aptitude is a must....systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Molina Healthcare (Columbus, GA)
- …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more
- STG International (Milledgeville, GA)
- …the effectiveness of those interventions when necessary. *Assist the Medical Director in the development and implementation of medical and nursing services ... reporting of crimes in accordance with federal, state and local guidelines. *Provide oversight for the admission, transfer and discharge of all residents from the… more
- State of Georgia (Gwinnett County, GA)
- …the Director . Manages the planning, development, and implementation of operational support services for a facility. Develops and implements policies and ... disabilities. View Point Health serves uninsured, underinsured, low-income Medicaid, Medicare , war veterans and some private insurance across multiple locations… more
- Molina Healthcare (GA)
- …strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core ... contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight . Tighter knit proximity ongoing after contract. * In conjunction… more
- Molina Healthcare (GA)
- …for the daily operations of the department working collaboratively with other operational departments and functional business unit stakeholders to lead or support ... outreach and resolving provider inquiries. + In conjunction with the Director , Provider Network Management & Operations, develops health plan-specific provider… more
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