- Molina Healthcare (GA)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Network staff ... contracting, provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the… more
- Humana (Atlanta, GA)
- …of matters related to PBM and pharmacy services, including regulatory compliance ; contract drafting, negotiation, and management; and risk management. This position ... benefit plans. + Provide legal guidance on federal and state regulatory compliance . + Advise on risk exposure, mitigation strategies, and legal implications of… more
- Cardinal Health (Atlanta, GA)
- …initiatives to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage ... for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends in denials and… more
- Grant Thornton (Atlanta, GA)
- …improvement, cost reduction, fraud prevention, internal control, and compliance . + Perform engagement management responsibilities, including project scheduling, ... key healthcare regulations and initiatives, and the ability to evaluate organizational compliance with regulatory bodies such as the Office of Inspector General… more
- Aveanna Healthcare (Atlanta, GA)
- …analysis of contract language, redlining and negotiation of terms to ensure compliance with Aveanna's guidelines. + Review, analyze and negotiate external contract ... all other contract types under the contracting team's responsibility for compliance with company guidelines and operational/financial risks. Communicate key terms… more
- AdventHealth (Calhoun, GA)
- …is responsible for customer satisfaction, financial management, regulatory compliance , Human Resources issues, employee competency, performance improvement, ... not in attendance have access to review meeting minutes. + Regulatory Compliance : + Complies with The Joint Commission (TJC) and Healthcare Facilities Accreditation… more
- Humana (Atlanta, GA)
- …pillars, including continuous integration (CI), continuous delivery (CD), quality, security, compliance , metrics, and reporting. + Ensure compliance with ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Waystar (Atlanta, GA)
- …subject matter experts to gather accurate and compelling technical, product, and compliance information. + Write, edit, and format responses to clearly address ... Security, and Legal to ensure responses meet client and compliance requirements. + Coordinate with internal teams and external...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- ChenMed (Decatur, GA)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... work closely with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and quality management… more
- Fresenius Medical Center (Summerville, GA)
- …nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and… more