• CDQI Nurse Specialist - Part Time - Remote

    Datavant (Atlanta, GA)
    …bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role in elevating ... to enhance documentation clarity, completeness, and overall medical record quality . By ensuring accurate and comprehensive physician documentation, you will… more
    Datavant (11/11/25)
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  • Medical Director-Payment Integrity

    Humana (Atlanta, GA)
    …of decisions to internal associates. The clinical scenarios predominantly arise from inpatient or post-acute care environments. A remote possibility exists of ... level of care, and/or requested site of service should be authorized at the Inpatient level. All work occurs within a context of regulatory compliance, and work is… more
    Humana (12/11/25)
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  • Professor, Interventional Cardiology, Division…

    Emory Healthcare/Emory University (Atlanta, GA)
    …and other advanced coronary and structural interventions as credentialed. 2. Inpatient Care Provide consultative services for hospitalized patients with acute and ... diseases, including pre- and post-procedural management. Collaborate with the inpatient cardiology, hospitalist, and intensive care teams to ensure coordinated,… more
    Emory Healthcare/Emory University (10/31/25)
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  • Medical Director - IP Claims Management

    Humana (Atlanta, GA)
    …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and ... post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled… more
    Humana (12/11/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (GA)
    …a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high speed required Work Schedule ... for a RN with experience with appeals, claims review, and medical coding . JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment… more
    Molina Healthcare (12/24/25)
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