- TEKsystems (Atlanta, GA)
- Program Specialist REMOTE Pay Rate: $21/hr Schedule: Ranges M-F 8am-8:30pm EST Anticipated Start Date: 12/1/2025 End Date: 3/31/2026 Contract length: 4 months ... Training period: 8 weeks (December 1 - February 1) Description The Program Specialist is responsible for serving as the customer's primary point of contact providing… more
- Cognizant (Atlanta, GA)
- **Schedule:** Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work ... based on the review of clinical documentation in accordance with Medicare , Medicaid, and third-party guidelines. . Effectively document and log claims/appeals… more
- Molina Healthcare (Columbus, GA)
- Molina Healthcare is in search of an experienced Sr Digital Marketing Specialist . The Sr. Specialist , Digital Marketing will be responsible for analyzing and ... communicator, and a desire to improve processes **Preferred:** + Medicaid or Medicare Health Plan experience + Strong analytical skills **PHYSICAL DEMANDS:** Working… more
- Molina Healthcare (Augusta, GA)
- …administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care ... services to low income, uninsured, and other populations. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports… more
- Bristol Myers Squibb (Atlanta, GA)
- …more: careers.bms.com/working-with-us . **Job Title** : NPPA Clinical Specialist **Therapeutic Area:** Dermatology **Territory:** Atlanta Metro **Position Summary:** ... core of decisions should apply. The NP PA Clinical Specialist will have no direct reports and report into...laws. + Possess a strong understanding of Commercial payers, Medicare plans and state Medicaid in geography. + Immunology… more
- Cardinal Health (Atlanta, GA)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of...hours of Monday-Friday, 7:00 AM to 8:00 PM CST. ** REMOTE DETAILS:** You will work remotely, full-time. It will… more
- Highmark Health (Atlanta, GA)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Molina Healthcare (GA)
- **_ Remote and must live in Georgia _** **JOB DESCRIPTION** **Job Summary** Provider Network Administration is responsible for the accurate and timely validation and ... Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other… more
- Evolent (Atlanta, GA)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Molina Healthcare (Augusta, GA)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience + Proven… more