- Evolent (Atlanta, GA)
- …discussions . Experience building and developing team members . Knowledge of the managed care and oncology market trends (both payers and risk-bearing ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...we seek to connect the pieces of fragmented health care system and ensure people get the same level… more
- Elevance Health (Atlanta, GA)
- …or post-doctoral training in conducting health services research with experience in biostatistics, managed care , health care systems, health policy, or ... in health services, health economics, and health policy evaluation of innovative care delivery models. + Support research activities in the following areas: research… more
- PruittHealth (Buford, GA)
- …offices. 7. Identifies key referring personnel in hospitals, nursing homes, and managed care operations, along with opportunities to increase referral volume ... to drive growth in our skilled nursing, rehabilitation and long-term care business. **KEY RESPONSIBILITIES:** 1. Develops, implements, and evaluates quarterly and… more
- Peachtree Orthopedics (Sandy Springs, GA)
- …Knowledge of ICD-10, CPT, HCPCS, and modifiers preferred. + Understanding of Medicare, managed care , and commercial insurance products and plans. + Familiarity ... offices across Greater Atlanta, we're committed to providing top-notch care and your skills and passion can make a...but we take pride in delivering dedicated and compassionate care to everyone who walks through our doors. If… more
- Humana (Atlanta, GA)
- …Professional Business Intelligence Engineer** is an experienced individual with broad Medicaid Managed Care expertise, deep analytics expertise, and a proven ... is to advance personalized solutions that foster whole person care to engage and empower our members in their...reporting and data analysis + 3+ years of health care experience for Medicare and/or Medicaid populations + Proven… more
- America's Best (Thomasville, GA)
- …phone calls in accordance with National Vision protocol. + Processes and understands managed care plans while obtaining document information from the insurance ... parts of the optical equation - eyewear and eye care - into one excellent experience at a single...their best. We help people by making quality eye care and eyewear more affordable and accessible. As the… more
- Humana (Atlanta, GA)
- …with Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional Information** **Work Schedule:** Monday-Friday ... policies and procedures ensuring best and most appropriate treatment, care or services for members. Bilingual Outbound Telephonic UM...and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana,… more
- Humana (Atlanta, GA)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. The Home Solutions UM Team is hiring for… more
- Ochsner Health (Savannah, GA)
- …and/or trauma upon the patient and their support system. + Advanced knowledge of managed care and public programs such as those funded by Medicare, Medicaid, ... and community agency personnel. + Advanced knowledge of an acute and chronic care medical setting, medical terminology and the psychosocial and economic effects of… more
- Prime Therapeutics (Atlanta, GA)
- …a regulatory or compliance role, with a minimum of 3 years of experience working with managed care companies or other health care clients Must be eligible to ... for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded...and work collaboratively to provide the highest quality of care and service to our members. If you are… more