- Humana (Atlanta, GA)
- …and plays a critical part in forecasting risk scores and revenue for the Medicare Advantage Part D business. The successful candidate will lead efforts to model ... FSA or plus relevant advanced degree + Experience with Medicare Part D + Familiarity with Risk Score Data...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Aveanna Healthcare (Atlanta, GA)
- …compensation practices and policies, and make recommendations to improve compliance , efficiencies, and competitive advantage + Administer all compensation components ... system, oversight and approval of compensation changes, maintenance of minimum wage compliance and FLSA compliance related to compensation, execution of annual… more
- Molina Healthcare (GA)
- …overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. **Knowledge/Skills/Abilities** ... plan for the Medicaid , CHIP, Marketplace, MMP and Medicare lines of business. * Works with staff and...* Oversees Enrollment and Contact Center Operations to ensure compliance with health plan requirements. Works collaboratively with Corporate… more
- State of Georgia (Fulton County, GA)
- …Georgia Medicaid Program. + Demonstrates thorough knowledge of and insures compliance with departmental policies and procedures governing the Georgia Medicaid ... Program; state and federal laws and policies governing Medicare and Medicaid. + Applies appropriate regulations, policies, and procedures to accurately determine… more
- Gentiva (Atlanta, GA)
- …clinical leader in our hospice locations across the region. You'll ensure compliance , lead quality initiatives, and support teams in delivering best-in-class care ... with the flexibility and skill to manage hospice operations while maintaining compliance with all federal, state, and organizational standards. **What You'll Do as… more
- Humana (Atlanta, GA)
- …time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work ... concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility… more
- Molina Healthcare (Columbus, GA)
- …oversight of processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has ... decision-making accountability for ensuring compliance with complex regulatory requirements, protecting the integrity of enterprise revenue, and enabling the… more
- Ochsner Health (Savannah, GA)
- …knowledge of managed care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage, and commercial insurance plans. + Proficiency in ... apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This...and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including… more
- Humana (Atlanta, GA)
- …with members while concurrently navigating multiple computer applications. To ensure compliance and support the auto dialer process essential to our business, ... communication and interpersonal skills. **Duties Include** + Telephonically work with Medicare members with transitional needs and complex chronic conditions. +… more
- Evolent (Atlanta, GA)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more