- National Vision (Lawrenceville, GA)
- …hard work is praised, and career growth is a reality. We are hiring for a Managed Care Customer Service Representative to join our growing team! This is an in ... see their best to live their best. We help people by making quality eye care and eyewear more affordable and accessible. National Vision is one of the largest… more
- Prime Therapeutics (Atlanta, GA)
- …area of study + 15 years of relevant work experience in PBM, pharmacy, health plan and/or managed care with a minimum of 8 years in Medicare and/or Medicaid in a ... **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government...of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That… more
- Humana (Atlanta, GA)
- …in private practice or other patient care + Minimum of 1 year of managed care experience **OR** A current, valid, and unrestricted license as a Mental Health ... or other patient care + Minimum of 1 year of managed care experience **OR** A current, valid, and unrestricted nursing license to include: **Registered… more
- Molina Healthcare (Augusta, GA)
- …experience in hospital acute care , inpatient review, prior authorization, managed care , or equivalent combination of relevant education and experience. ... unit (ICU) or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of… more
- CVS Health (Atlanta, GA)
- …mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Aetna policies and procedures * Works ... includes navigating multiple systems and keyboarding. **Preferred Qualifications** * Previous Managed Care experience. * Psychology or Social Services… more
- Cardinal Health (Atlanta, GA)
- …business including Medicare, Medicaid, and various commercial markets. The Advisor of Managed Care -National Accounts is responsible for regional retail (chain) ... pharmacy accounts from a managed care contracting perspective. The primary purpose of this role is to maintain our managed care relationship with current… more
- Highmark Health (Atlanta, GA)
- …specialization + Experience in a Clinical Setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES or CERTIFICATIONS** **Required** + Current State ... utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,… more
- Elevance Health (Atlanta, GA)
- …or related field; minimum of 5 years of experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... **Provider Contract/Cost of Care Consultant** **Location:** This role requires associates to...granted as required by law. The **Provider Contract/Cost of Care Consultant** provides analytical support to the Cost of… more
- Elevance Health (Atlanta, GA)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Cost of Care /Provider Contracting Data Analyst Senior** **Location:** This role...is granted as required by law. The **Cost of Care /Provider Contracting Data Analyst Senior** is responsible for providing… more
- Elevance Health (Atlanta, GA)
- …or related field and a minimum of 7 years of experience in broad-based analytical, managed care payor or provider environment as well as in depth experience in ... **Provider Contract/Cost of Care Consultant Senior** **Location:** This role requires associates...granted as required by law. The **Provider Contract/Cost of Care Consultant Senior** provides the highest level of analytical… more