• Senior Medical Director…

    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
    Molina Healthcare (06/13/25)
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  • Lead Director , Medicare Actuarial…

    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
    CVS Health (07/01/25)
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  • Field Medical Director…

    Evolent (Atlanta, GA)
    …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** +...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (07/30/25)
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  • Field Medical Director , Cardiology

    Evolent (Atlanta, GA)
    …Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications -...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (07/02/25)
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  • Field Medical Director , Oncology

    Evolent (Atlanta, GA)
    …MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (05/20/25)
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  • Field Medical Director , MSK Surgery

    Evolent (Atlanta, GA)
    …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (07/04/25)
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  • Clinical Documentation and Claims Integrity…

    Elevance Health (Atlanta, GA)
    **Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... home-care and community based services. The **Clinical Document Improvement Director ** is responsible for leading encounter processing, diagnostic documentation and… more
    Elevance Health (07/18/25)
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  • Associate Medical Director…

    Evolent (Atlanta, GA)
    …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... with cross-functional teams, including **clinical reviewers, product, management, and senior leadership,** to improve decision-making and care outcomes. + Assist… more
    Evolent (06/03/25)
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  • Director & Actuary II

    Elevance Health (Atlanta, GA)
    ** Director & Actuary II** **Location** : _This role requires associates to be in-office_ **_3 days per week_** _, fostering collaboration and connectivity, while ... for employment, unless an accommodation is granted as required by law._ The ** Director & Actuary II** is responsible for directing actuarial research required to… more
    Elevance Health (07/25/25)
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  • Patient Care Manager Senior

    Gentiva (Conyers, GA)
    …functions, including documenting referrals, new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining ... **Overview** We're looking for a **Patient Care Manager Senior ** to join our team. You will report...our team. You will report directly to the Executive Director or Administrator. You will be responsible for assisting… more
    Gentiva (07/25/25)
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