- Prime Therapeutics (Atlanta, GA)
- …strategy. This role provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality ... goals + Drive the client quality strategy for all lines of business ( Medicare , Medicaid, Commercial/HIM); serve as primary point of contact and subject matter expert… more
- CenterWell (Scottdale, GA)
- …Medicine or Geriatric Medicine preferr + Active and unrestricted DEA license + Medicare Provider Number + Minimum of two to five years directly applicable ... experiencepreferred + Experience managing Medicare Advantage panel of patients with understanding of Best...largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health… more
- CenterWell (Morrow, GA)
- …for TB. **Preferred Qualifications:** . Active and unrestricted DEA license . Medicare Provider Number/ Medicaid Provider Number . Experience managing Medicare ... care environment in a value based relationship environment. . Knowledge of Medicare guidelines and coverage. . Knowledge of HEDIS quality indicators. **Additional… more
- State of Georgia (Richmond County, GA)
- …must perform the following duties: Must have experience in Patient Billing in Medicare , Medicaid, or 3rd Party Insurance. + Oversee interviews and data entry to ... prior authorizations, and monitor client eligibility for benefits like Social Security, Medicare , and Medicaid. + Track and report Medicare credit balances,… more
- Prime Therapeutics (Atlanta, GA)
- …Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid) + Other duties as assigned **Education & Experience** + ... legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated...or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- CenterWell (Augusta, GA)
- …for TB. **Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare ... care environment in a value based relationship environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional… more
- CenterWell (Atlanta, GA)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of two to five ... years directly applicable experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more
- Humana (Atlanta, GA)
- …to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries leveraging data science & analytics, clinical expertise, strategic ... to define various clinical concepts and extract clinical information from medical, pharmacy , and lab claims for analytics and modeling purposes + Translates analytic… more
- Cardinal Health (Atlanta, GA)
- …including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while planning for various scenarios that may impact prescribed products ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more
- Cardinal Health (Atlanta, GA)
- …streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, ... a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred +… more