- Molina Healthcare (Atlanta, GA)
- …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
- Molina Healthcare (Atlanta, GA)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (Atlanta, GA)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Atlanta, GA)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
- Molina Healthcare (Atlanta, GA)
- …and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's ... for leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible...DSNP, HIDE, FIDE, EAE, AIP, etc. * Provides direct oversight , monitoring and training of provider disputes and appeals… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Associate Director , Compliance ensures compliance with governmental requirements. The Associate Director , ... required to work in either Central or Eastern Time. Associate Director , Regulatory Intake Compliance is responsible for enterprise-wide regulatory monitoring,… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Director , Clinical and Revenue Integrity Operations is responsible for the oversight and management of our team of Revenue Integrity ... to be an integral part of ongoing product and operational strategy. Technical and process aptitude is a must....systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Molina Healthcare (Atlanta, GA)
- …in collaboration with the Manager or Director . * Keeps Manager or Director apprised of operational issues, including staffing resources, program and system ... drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient… more
- City of Alpharetta, Georgia (Alpharetta, GA)
- …Starting salary $81,350 to $91,350. Under administrative direction of the Director of Economic Development, performs a variety of professional-level duties in ... development programs, incentives, and special projects as assigned by the Director of Economic Development; including participating in the development and… more
- State of Georgia (Gwinnett County, GA)
- …the Director . Manages the planning, development, and implementation of operational support services for a facility. Develops and implements policies and ... disabilities. View Point Health serves uninsured, underinsured, low-income Medicaid, Medicare , war veterans and some private insurance across multiple locations… more
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