- Abt Global Inc. (Atlanta, GA)
- … projects + Demonstrate and apply knowledge of state and federal Medicaid and CHIP managed care regulations, program implementation, and monitoring ... subcontractors) related to state and federal Medicaid /CHIP and Medicaid /CHIP managed care expertise required. + Experience and interest in leading or… more
- Molina Healthcare (Atlanta, GA)
- …of education and experience **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 8+ years of Medicaid managed care experience or in an equivalent related ... with Medicaid Proposals and/or business development and requires demonstrated Medicaid managed care experience comprised of technical operational,… more
- Prime Therapeutics (Atlanta, GA)
- …or within Medicare/ Medicaid (eg insurance, government program operations, managed care practices, and/or provider contracting) + Paralegal certification ... **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior Contract Representative is responsible...+ Experience with analyzing state and federal regulations + Experience using Contract Management… more
- Prime Therapeutics (Atlanta, GA)
- …and execution of the strategic vision and business plan for Prime's state Medicaid market, including business development and client relationship management, ... objectives + Maintain and leverage a deep knowledge of State Medicaid landscape to analyze and interpret...include 8 years of experience leading operations of a managed care and/or health services company, or… more
- Molina Healthcare (Atlanta, GA)
- …terms or facilitate business objectives. + Leads efforts with Plan Presidents to expand managed care and other health plan business opportunities (such as duals, ... Policy or Business Administration. **PREFERRED EXPERIENCE** : Experience working in the managed care industry, particularly with health plans that contract with… more
- Humana (Atlanta, GA)
- …5+ years of established clinical experience + Knowledge of the managed care industry including Medicare or Medicaid products + Possess analysis and ... other reference sources. Medical Director will learn National LTSS State Medicaid requirements (currently FL; IN; and...+ The Medical Director conducts clinical reviews of the care received by members in assigned LTSS Medicaid… more
- Humana (Atlanta, GA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, ... experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national… more
- Molina Healthcare (Atlanta, GA)
- …and productivity is important. Preferred candidates will have previous case management, managed care , hospital, and/or home health experience._ _This role is ... have a current active unrestricted RN license in the state of CA._ _Case Manager RN will work in...Manager RN will work in remote setting supporting our Medicare/ Medicaid population who have recently been admitted into Hospital.… more
- Humana (Atlanta, GA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, ... experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national… more
- Molina Healthcare (Atlanta, GA)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... of medical staff services. Maintains a working knowledge of applicable national, state , and local laws and regulatory requirements affecting the medical and clinical… more