- Molina Healthcare (Savannah, GA)
- …+ 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare ... Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie,… more
- Cardinal Health (Atlanta, GA)
- …OH. The _Director of Business Development, Market Access_ is a seasoned managed care executive and strategic individual contributor responsible for developing ... contract lifecycle. + Serve as the external subject matter expert on managed care , value-based payment methodologies, and population health trends, leveraging… more
- Molina Healthcare (Columbus, GA)
- …+ 2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare ... discuss and resolve issues related to utilization management, pharmacy, quality of care , and correct coding, for example. + Independently delivers training and… more
- The Cigna Group (Atlanta, GA)
- …preferred. Also open to someone with equivalent experience. + 5+ years of managed health care experience in communications. Dental experience strongly preferred. ... **Position Summary** The Dental Health Care Provider (HCP) Communications position is accountable for developing dental HCP communications and marketing materials… more
- Humana (Atlanta, GA)
- …adapt and the courage to innovate. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid. ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Atlanta, GA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Molina Healthcare (Columbus, GA)
- …health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with retrieving specified ... utilized in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Humana (Atlanta, GA)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Atlanta, GA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
- Molina Healthcare (Atlanta, GA)
- …requests from outside agencies. **Required Qualifications** * At least 2 years of managed care experience in a call center, appeals, and/or claims environment, ... program(s) proficiency. **Preferred Qualifications** * Customer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other… more