- Elevance Health (Atlanta, GA)
- …with appropriate actions (provider education, recovery of monies, cost avoidance, recommending sanctions or other actions) + Assists with development of audit tools, ... policies and procedures and educational materials + Acts as liaison with service operations as well as other areas of the company relative to claims reviews and their status + Analyzes and trends performance data, and works with service operations to improve… more
- UNUM (Dunwoody, GA)
- …benefit area employees regulated by this Rule. **HIPAA Privacy Training and Sanctions ** All employees who have access to health information whose confidentiality is ... protected by the HIPAA Privacy Rule are required by the Rule to receive training so that they have an understanding and knowledge of the Privacy Rule that corresponds to their job responsibilities and of the group health plan's policies and procedures that… more
- Bank of America (Atlanta, GA)
- …This job is responsible for executing substantive money laundering, economic sanctions and fraud compliance and operational risk practices. Key responsibilities ... include working directly or through compliance officers for the Front Line Units (FLUs) and Control Functions (CFs) to complete compliance, policy, operational/fraud risk management requirements. The Global Financial Crimes Manager - Policy & Standards is a… more
- Bank of America (Atlanta, GA)
- …This job is responsible for executing substantive money laundering, economic sanctions and fraud compliance and operational risk practices forCrypto Currency, ... Digital Assets, and Payments within the Global Payment Solutionsbusiness. Key responsibilities include working directly or through the emerging risk, compliance officers for the Front Line Units (FLUs) and Control Functions (CFs) to complete compliance,… more
- Bank of America (Atlanta, GA)
- …This job is responsible for executing substantive money laundering, economic sanctions and fraud compliance and operational risk practices. Key responsibilities ... include working directly or through compliance officers for the Front Line Units (FLUs) and Control Functions (CFs) to complete compliance, policy, operational/fraud risk management requirements. **Responsibilities:** + Advises and directs the development and… more
- Molina Healthcare (Augusta, GA)
- …**:** Current state Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare. **PR** **E** **FE** **R** **RED ED** **U** ... **C** **A** **TI** **O** **N** **:** Master's in Business Administration, Public Health, Healthcare Administration, etc. **PR** **E** **FE** **R** **RED E** **X** **PE** **R** **I** **E** **N** **C** **E:** + Peer Review, medical policy/procedure development,… more
- The Hertz Corporation (Atlanta, GA)
- …knowledge of key compliance topics, such as anticorruption, economic/trade sanctions , fraud, antitrust, etc., including as regulatory requirements and compliance ... program management best practices. + Professional certification (CPA, CFE, CCEP) is preferred. + Exceptional analytical, problem solving, interpersonal, and written and verbal communication skills, with proven experience in conducting training sessions. +… more
- Molina Healthcare (Atlanta, GA)
- …state Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare. **PREFERRED EDUCATION:** Master's in Business Administration, ... Public Health, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA… more
- Molina Healthcare (Augusta, GA)
- …Association** Active and unrestricted State (TX) Medical License, free of sanctions from Medicaid or Medicare. **Preferred Experience** * Peer Review, medical ... policy/procedure development, provider contracting experience. * Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical… more
- Humana (Atlanta, GA)
- …of direct clinical patient care experience post residency or fellowship** + **No sanctions from Federal or State Governmental organizations** + **The ability to pass ... credentialing requirements** + **Excellent verbal and written communication skills with analytic and interpretative skills** + **Participate in educational activities by attending required conferences and also create content to lead/teach/present for… more