- Gentiva (Atlanta, GA)
- …andbe responsible for preparing, reviewing, analyzing, and responding to requests for managed care , provider, and other related healthcare agreements. + Prepares ... and negotiates agreements with contracting agencies/payors. + Consults frequently with operations in the contract preparation process. + Prepares projects by obtaining support information and data from various sources (branch personnel, regulatory department,… more
- Molina Healthcare (Columbus, GA)
- …or equivalent combination of education and experience **Required Experience** + Min. 3 years managed care experience + Experience in one or more of the ... following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria. **Preferred Education** Bachelor's Degree… more
- Molina Healthcare (Columbus, GA)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** + 3-5 years of formal training in Project Management + Experience… more
- Aveanna Healthcare (Atlanta, GA)
- …with the payer relations team to support end to end contracting activities for managed care payers including review and analysis of contract language, redlining ... and negotiation of terms to ensure compliance with Aveanna's guidelines. + Review, analyze and negotiate external contract documents provided by contracting party for all other contract types under the contracting team's responsibility for compliance with… more
- Molina Healthcare (Savannah, GA)
- …**N** **C** **E:** + 3+ years of medical record abstraction experience + 3+ years managed care experience. + Advanced knowledge of HEDIS and NCQA. **PR** **E** ... **FE** **R** **RED L** **I** **C** **E** **N** **S** **E,** **C** **E** **R** **TI** **FI** **C** **A** **T** **I** **O** **N** **, AS** **S** **O** **C** **I** **A** **TI** **O** **N** **:** Active RN license for the State(s) of employment **PHY** **S** **I**… more
- Elevance Health (Atlanta, GA)
- …would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:** + Managed care , payer or pharmacy benefit manager (PBM), or related ... sector experience highly preferred. + Post-graduate or post-doctoral training or relevant experience in conducting health research highly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and procedures. + Serves as the provider on record for appropriate managed care intervention claims with responsibility for appropriate documentation, ... implementation, monitoring, and billing of autism behavioral intervention. + Provides parent support, coordination, and consultative services. + Conducts specialized training of students and professionals. + Represents the program at meetings and conferences… more
- Grifols Shared Services North America, Inc (Augusta, GA)
- …presentations to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and ... medical schools. Acts as an "ambassador" representing Grifols' position and interests. + Participates and contributes in cross-functional teams (eg, sales, marketing, global medical affairs) regarding field-based activities, medical insights, competitor… more
- Molina Healthcare (Atlanta, GA)
- …adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either ... at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct secondary pricing logic and compliance with configuration and regulatory rules. + Analyze claim outcomes and identify trends or… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …_PRN / Registry_ **Job Number** _150438_ **Job Category** _Revenue Cycle & Managed Care_ **Schedule** _Other_ **Standard Hours** _12 Hours_ **Hourly Minimum** _USD ... $0.00/Hr._ **Hourly Midpoint** _USD $0.00/Hr._ Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and… more