• Medical Director, Clinical Services

    Highmark Health (Atlanta, GA)
    …year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or ... + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL,… more
    Highmark Health (07/29/25)
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  • Deputy General Counsel, Litigation - REMOTE

    Prime Therapeutics (Atlanta, GA)
    …work experience, including 12 years of experience as an attorney and 5 years representing managed care companies, health care clients, or clients in highly ... Anti-Kickback Statute, and False Claims Act, with a focus on PBM and managed care operations + Experience engaging with regulatory bodies (eg, CMS, OIG, state… more
    Prime Therapeutics (07/19/25)
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  • Policy Clinical Pharmacist- REMOTE

    Prime Therapeutics (Atlanta, GA)
    …(PharmD) or Bachelor of Science Pharmacy Degree + 1 years of pharmacy, managed care and/or pharmaceutical industry experience + Current pharmacist license in ... as a team. + Data review and interpretation skills required. **Preferred Qualifications** + Managed care experience (Health Plan or PBM) + Oncology experience +… more
    Prime Therapeutics (08/28/25)
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  • Lead Director, Project Program Management…

    CVS Health (Atlanta, GA)
    …significance or those yielding cost savings. + 10+ years of experience in managed care , health insurance, marketing, or related industries. + Competency in ... organizational levels, including executive leadership. **Preferred Qualifications** + Experience within managed care or the health insurance industry. +… more
    CVS Health (08/28/25)
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  • Senior Analyst, Quality Management

    CVS Health (Atlanta, GA)
    …activities on performance **Required Qualifications** * At least 5 years experience in managed care , hospital, or similar healthcare environment * Must have ... internal and external stakeholders **Preferred Qualifications** * Medicaid and/or Medicare managed care experience **Education** * Master's degree or equivalent… more
    CVS Health (08/24/25)
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  • Clinical Pharmacist (Algo), Professional-Senior-…

    Prime Therapeutics (Atlanta, GA)
    …(PharmD) or Bachelor of Science Pharmacy Degree + 1 years of pharmacy, managed care and/or pharmaceutical industry experience + Current pharmacist license in ... as a team. + Data review and interpretation skills required. **Preferred Qualifications** + Managed care experience (Health Plan or PBM) + Oncology experience +… more
    Prime Therapeutics (08/19/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (GA)
    …with a minimum of 2 years' experience in health plan member interventions, managed care , or equivalent experience. + Demonstrated solid business writing ... QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or interpretation + Certified… more
    Molina Healthcare (07/31/25)
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  • Credentialing Verification Specalist

    Emory Healthcare/Emory University (Atlanta, GA)
    …diploma or equivalent and one year of credentialing experience in an acute care hospital, managed care organization and/or credentialing verification ... _Regular Full-Time_ **Job Number** _136917_ **Job Category** _Revenue Cycle & Managed Care_ **Schedule** _8a-4:30p_ **Standard Hours** _40 Hours_ **Hourly Minimum**… more
    Emory Healthcare/Emory University (08/29/25)
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  • Credentialing Verification Specialist

    Emory Healthcare/Emory University (Atlanta, GA)
    …diploma or equivalent and one year of credentialing experience in an acute care hospital, managed care organization and/or credentialing verification ... _Regular Full-Time_ **Job Number** _146633_ **Job Category** _Revenue Cycle & Managed Care_ **Schedule** _8a-4:30p_ **Standard Hours** _40 Hours_ **Hourly Minimum**… more
    Emory Healthcare/Emory University (08/29/25)
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  • Manager, Medical Economics (Medicaid) - REMOTE

    Molina Healthcare (Columbus, GA)
    …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
    Molina Healthcare (08/27/25)
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