- Deloitte (Atlanta, GA)
- …engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and fee-for-service, Medicaid policy, budget forecasting ... plan/insurance company experience + 1+ year(s) of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development… more
- Trinity Health (Lavonia, GA)
- …Medicaid, Social Security Disability, Tricare, and Supplemental Security Income Disability), managed care contracts and coordination of benefits is highly ... (1-3) years within a hospital or clinic environment, an insurance company, managed care organization or other health care financial service setting,… more
- Elevance Health (Atlanta, GA)
- …experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which ... the ability to interpret and apply member contracts, member benefits, and managed care products is strongly preferred. Please be advised that Elevance Health… more
- Prime Therapeutics (Atlanta, GA)
- …is located + 3 years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at least 2 years of work experience in a ... clinical and/or managed care setting Must be eligible to work in the United States without the need for work visa or residency sponsorship **Additional… more
- Humana (Atlanta, GA)
- …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... staff to provide Humana members with optimal value based care in accordance with Medicare and Humana policy. All...a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial health insurance + Current and… more
- 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
- Molina Healthcare (Columbus, GA)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and… more
- Boehringer Ingelheim (Savannah, GA)
- …comprehensive discussions on the payer environment, co-pays, and formulary access. Works with Managed Care Area Managers to generate and sustain support for ... additional responsibilities in teaching hospitals, federal and military hospitals, managed health care facilities, group purchasing organizations, integrated… more
- 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 ... Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care /handling injuries, Radiation, Shift work, Travel may be required. Use… more
- J&J Family of Companies (Atlanta, GA)
- …long-term sales potential relevant to percentage of patients treated, patient mix, Managed Care organizations and Specialty Pharmacies, and new protocols or ... + Experience in hospital and large account sales, understand complex reimbursement and managed care dynamics with a documented history of successful sales… more