- Elevance Health (Atlanta, GA)
- …on data related to Pharmacy cost of care, pharmacy trends, and other Medicare book of business' related issues/metrics. **How you will make an impact:** + ... to identify cost drivers and trend patterns within the Medicare Part D Individual and Group markets + Identifies...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- CenterWell (Savannah, GA)
- …consumer experiences **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to ... five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated… more
- Molina Healthcare (Atlanta, GA)
- …Lead will also be responsible for management of the Inside Sales team for all Medicare States when the Supervisor is out. This Team Lead will assist the Supervisor ... cards for trends. Reinforces accountability and notifies the Local Inside Sales Manager of any needs for corrective action. Resolves conflict, motivates staff, and… more
- Aveanna Healthcare (Atlanta, GA)
- …we serve. Requirements Position Overview The Biller reports directly to the Billing Manager and is responsible for the proper and complete handling of all unbilled ... guarantors for services provided. This is inclusive of claims to commercial, Medicare , Medicaid and private pay accounts. Essential Job Functions Maintains current… more
- Gentiva (Savannah, GA)
- …operations, ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure ... operations leadership + Strong understanding of hospice regulations, compliance, and Medicare conditions of participation + Proven ability to manage teams, budgets,… more
- CenterWell (Atlanta, GA)
- …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- Molina Healthcare (GA)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with… more
- Evolent (Atlanta, GA)
- …to find the most valuable defects. The IQA reports to a associate director or a manager . One or many IQAs may be engaged in any testing effort **What You Will Be ... risks and issues in coordination with the lead / manager for status reporting + Responsible to enforce department...Good knowledge US Healthcare - Payer side, Knowledge of Medicare , Medicaid, Commercial Plans and understanding on claims workflow,… more
- Waystar (Atlanta, GA)
- …**WHAT YOU'LL DO** + Proposes technical solutions to the Manager , Application Engineering + Designs/develops/tests/implements improvements or new features into ... various stages to production + Identifies and informs the Manager , Application Engineering of areas of the application that...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Waystar (Atlanta, GA)
- …well. **WHAT YOU'LL DO** + Proposes technical solutions to the Manager , Application Engineering + Designs/develops/tests/implements improvements or new features into ... various stages to production + Identifies and informs the Manager , Application Engineering of areas of the application that...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more