- Humana (Atlanta, GA)
- …information to the application at Humana's secure website. + Position reports to Manager , Technology Solutions, IT HPE - Digital Channels & Contact Centers + ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Elevance Health (Atlanta, GA)
- …authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations. ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Prime Therapeutics (Atlanta, GA)
- …resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments within project + Educate and advance ... Benefit Management (PBM) or healthcare experience with understanding of Medicare , Medicaid, the Exchanges along with regulatory compliance requirements (HIPAA… more
- Elevance Health (Atlanta, GA)
- …and problem-solving skills preferred. + Provider contract knowledge preferred. + Medicare Group Retiree experience preferred. Please be advised that Elevance Health ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (Atlanta, GA)
- …advanced analytics and actuarial innovation across Local Group, Individual, Medicaid, and Medicare businesses. We are pioneering the use of weekly trend data, ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (Atlanta, GA)
- …Center (CPCC) team. The CPCC is a clinical pharmacy call center that services Medicare , Medicaid, and the Commercial member populations. The members we reach out to ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Humana (Atlanta, GA)
- …largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical, ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (Savannah, GA)
- …that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined ... HCS Department staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and direction of… more
- Molina Healthcare (Savannah, GA)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in Healthcare… more
- Humana (Atlanta, GA)
- …researching and resolving provider reimbursement inquiries + Experience with Optum Rate Manager + Experience with Optum WebStrat or PSI applications + Experience ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more