- CVS Health (Atlanta, GA)
- …Services) requires regulatory changes during the plan year. The ** Medicare ** ** Benefits Standards & Guidance Lead Director** ensures accountability for ... enrollment, Special Needs Plans (SNP) and Employer Groups. The ** Medicare ** ** Benefits Standards & Guidance Lead Director** acts as the point of contact… more
- Prime Therapeutics (Atlanta, GA)
- …decision we make. **Job Posting Title** Compliance Analyst Sr--Medical Pharmacy Specialty/ Medicare Part B- REMOTE **Job Description** The Senior Compliance Analyst ... that business operations are aligned with expectations of applicable regulatory guidance + Lead project management efforts for highly sensitive Compliance… more
- Humana (Atlanta, GA)
- …professionals in compliance with review policies, procedures, and performance standards . Represents Humana at Administrative Law Judge hearings. Exercises ... established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be passionate about… more
- Humana (Atlanta, GA)
- …the adoption and delivery of the Humana Enterprise Architecture principles, standards , policies and methodologies. As a Senior Enterprise Architect, you play ... role in the alignment of the business vision, technology strategy and framing enterprise standards . You will be an integral part of the delivery of critical business… more
- Humana (Atlanta, GA)
- …and differentiated user-centered ecommerce experiences for individuals looking to purchase Medicare Advantage health plans. The team is focused on taking a ... in every aspect individually but ensure teams delivery high-quality outcomes through their guidance and oversight. **As a User Experience Design Lead, you will:** +… more
- Humana (Atlanta, GA)
- …correctly the first time. Expert level of coding knowledge specific to Medicare and Medicaid guidelines is a must. Understands department, segment, and ... occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Fosters relationships between Code Edit Management, internal… more
- Humana (Atlanta, GA)
- …the adoption and delivery of the Humana Enterprise Architecture principles, standards , policies and methodologies. As a Senior Enterprise Architect, you play ... as a Senior Enterprise Architect, you will provide mentorship and guidance to other enterprise, solution, technology and system architects across Humana.… more
- CenterWell (Atlanta, GA)
- …for coding staff to ensure continuous skill development and compliance with coding standards . + Partner with analytics and audit to identify coder errors and develop ... to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record of working… more
- Aveanna Healthcare (Duluth, GA)
- …Details Position Overview: TheClinical Manager - Hospiceworks under the direction and guidance of the Branch Administrator to provide supervision of all clinical ... services are delivered according to licensing guidelines, professional medical standards and agency policies and procedures. * This position...+ 401(k) with match + Health, Dental and Vision Benefits for employees at 30+ hours + Tuition Discounts… more
- Molina Healthcare (Atlanta, GA)
- …_** **Job Description** **Job Summary** Molina's Provider Contracting function provides guidance , signature support services, standards and resources to help ... programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements… more