- Summit Health (Atlanta, GA)
- …patients' homes and virtually through VillageMD and our operating companies Village Medical , Village Medical at Home, Summit Health, CityMD, and Starling ... @starlingphysicians.com, or @bmctotalcare.com. Job Description Integral to the team, the Director of Care Management will handle a wide range of projects… more
- CenterWell Primary Care (Duluth, GA)
- …our caring community and help us put health first Reports To: Associate Director , Home Health Branch Administrator FLSA: Exempt Work Schedule : Full-time/40 Hours ... final audits/billing are completed timely and in compliance with Medicare regulations. Coordinates communication between team members/attending physicians/caregivers to… more
- City of Alpharetta, GA (Alpharetta, GA)
- …(age 55+ and 10+ yrs. of service) may continue individual coverage up until Medicare eligibility at age 65. Medical Reimbursement : retirees (age 55+ and ... the written recommendation from the Police Officer's Captain. Obtain approval from the Director of Public Safety for the Police Officer to advance to Master Police… more
- Enhabit Home Health & Hospice (Athens, GA)
- …is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, Enhabit is consistently ranked as one of the best places ... Matching 401(k) plan for all employees Comprehensive insurance plans for medical , dental and vision coverage for full-time employees Supplemental insurance policies… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Molina Healthcare (Macon, GA)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- CVS Health (Atlanta, GA)
- …We are seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The ideal ... candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies. This role requires a strong… more
- Elevance Health (Atlanta, GA)
- …records of denied services for medical necessity. + Extrapolates and summarizes medical information for medical director , consultants and other external ... Medicare ** is responsible for investigating and processing and medical necessity appeals requests from members and providers. **How...to either uphold or deny appeal and forwards to Medical Director for approval. + Ensures that… more
