- Fujifilm (Atlanta, GA)
- …on the Fujifilm Healthcare Code of Conduct, Interactions with Healthcare Professionals Policy, Anti-Kickback, False Claims Act, HIPAA, Anti-Corruption Policy ... **Minimum of 2 years of experience with Antitrust.** + Strong understanding of healthcare regulations (eg, Anti-Kickback Statute, False Claims Act) and global… more
- Norstella (Atlanta, GA)
- …relational databases, ensuring data accuracy and quality. * Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data, ... unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and EMR data. You will be...worked in and understands the dynamics of the US healthcare ecosystem. **Responsibilities:** * Lead the delivery of complex… more
- Waystar (Atlanta, GA)
- …reports, and assessing strengths and weaknesses of competitors + Studying healthcare industry standards and staying up-to-date on industry changes and compliance ... and the provider reimbursement process, obtained either through direct experience in a healthcare setting or an RCM focused HIT company + Provided leadership on a… more
- Humana (Atlanta, GA)
- …medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, ... management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management… more
- Elevance Health (Atlanta, GA)
- …acumen strongly preferred. + Prior experience with managed care, trend & healthcare analytics, provider networks, claims , finance, and operations strongly ... human capital resources, and partners with care management, network, claims & operational teams, IT, and business partners. +...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Prime Therapeutics (Atlanta, GA)
- …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... 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
- Humana (Atlanta, GA)
- …operations, technology, communications, and processes + Solid understanding of healthcare operations, particularly around claims processing, enrollment, provider ... make an impact** **Required Qualifications** + Bachelor's degree in healthcare administration, public health, information systems, business, policy administration or… more
- Waystar (Atlanta, GA)
- …Machine Learning and predictive algorithms + Docker/Kubernetes + Familiarity with Healthcare domain including HL7, Claims /Payments data models **ABOUT WAYSTAR** ... passionate software professionals in an engineering-led culture to make healthcare better.Design and implement highly resilient, scalable, and performant solutions… more
- Emory Healthcare/Emory University (Atlanta, GA)
- **Overview** **Be inspired** **.** **Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel your professional journey with better benefits, ... Partner reports to the Chief Compliance Officer of Emory Healthcare (CCO EHC) and is responsible for supporting the...compliance and privacy laws, including HIPAA and the False Claims Act 2. Proven experience in audits, investigations, and… more
- Insight Global (Alpharetta, GA)
- …vector databases and building efficient data pipelines for RAG. Experience within the healthcare industry Experience working with claims and healthcare ... This role is responsible for the full lifecycle of AI feature delivery-from crafting best-in-class prompts and designing autonomous agents to ensuring secure, performant, and reliable deployment within mission-critical enterprise systems. The ideal candidate… more