- Elevance Health (Atlanta, GA)
- …evaluating and responding to financial risks inherent in the pricing and development of health insurance products. **How you will make an impact:** + Prepares ... data scientists, statisticians and actuaries preferred. + Experience working with large health claims datasets or gathering datasets. Experience with evaluation… more
- Elevance Health (Atlanta, GA)
- …organizations. **How you will make an impact:** + Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network ... to management. + Uses analytic tools to track both health risks and compliance, as well as supporting the...skills preferred. + Provider contract knowledge preferred. + Medicare Group Retiree experience preferred. Please be advised that Elevance… more
- Elevance Health (Atlanta, GA)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... Typically works with one provider type, eg physician, ancillary, or medical group . Provides advice and analytic support to Medical Directors, contract negotiators… more
- Catholic Health Initiatives (Ringgold, GA)
- …days off), Professional Dues, and Certification Reimbursement + Malpractice and Tail Insurance (Modified Claims Made) + Full Benefits Eligibility with ... **Job Summary and Responsibilities** CHI Memorial Medical Group is offering an outstanding GI opportunity in...services in a unique practice model. As an integrated health system, candidates will enjoy a highly collaborative environment… more
- Highmark Health (Atlanta, GA)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... of contracts by tracking utilization and competitive environment, including group specific performance guarantees. + Analyze and develop network retention… more
- AIG (Atlanta, GA)
- …investigate, evaluate and resolve Commercial General Liability and Auto Liability claims . Provides exceptional customer service and commitment to bring assigned ... plans based upon the applicable law, coverage and supporting evidence. Assigned claims typically consists of medium to moderate complex litigated and non-litigated… more
- Molina Healthcare (Atlanta, GA)
- …**Preferred Experience** + 2+ years of experience working in the group health business preferred, particularly within claims processing or operations. + A ... working knowledge of Local, State & Federal laws and regulations pertaining to health insurance , investigations & legal processes (Commercial insurance ,… more
- JE Dunn Construction Company (Atlanta, GA)
- …external insurance company contacts in reporting and managing safety-related claims and assists Safety team members in monitoring medical treatment of injured ... us in our pursuit of building perfection.** _JE Dunn's Advanced Facilities Group (AFG) combines Mission Critical, Advanced Industries, and Industrial & Manufacturing… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …improvement **Qualifications** **Education and Experience:** + Bachelor's degree in Life Sciences, Health Economics, Public Health , or related field required + ... teams with a pharmaceutical or biotech company, CRO, academic research, or HEOR group + Prior experience in Independent Medical Education (IME) / Grants Management… more
- CenterWell (Atlanta, GA)
- …medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. + ... first** The Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve… more