The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and ...
New
The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and ...
New
The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and ...
New
The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and ...
New
Data Analytics Manager (00056274)
Atlanta, GA · Hybrid
$56K - $73K/yr
The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and ...
Data Analytics Manager (00056274)
Atlanta, GA · Hybrid
$56K - $73K/yr
The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and ...
Compliance Specialist 3 (00180591)
Atlanta, GA · Hybrid
$56K - $73K/yr
DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and ... The position provides critical support functions within the Program Integrity Unit and the Office ...
Compliance Specialist 3 (00180591)
Atlanta, GA · Hybrid
$56K - $73K/yr
DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and ... The position provides critical support functions within the Program Integrity Unit and the Office ...
Familiarity with federal and state program integrity frameworks (Medicare/Medicaid managed care environments) preferred * Experience in hospital billing, facility claims auditing, payment integrity ...
New
Familiarity with federal and state program integrity frameworks (Medicare/Medicaid managed care environments) preferred * Experience in hospital billing, facility claims auditing, payment integrity ...
New
DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and ... The position provides critical support functions within the Program Integrity Unit and the Office ...
New
DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and ... The position provides critical support functions within the Program Integrity Unit and the Office ...
New
DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and ... The position provides critical support functions within the Program Integrity Unit and the Office ...
New
DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and ... The position provides critical support functions within the Program Integrity Unit and the Office ...
New
Direct experience with Medicaid systems and data sources such as MMIS, data warehouses/lakes, eligibility systems, provider systems, managed care data, or program integrity tools. * Experience with ...
Direct experience with Medicaid systems and data sources such as MMIS, data warehouses/lakes, eligibility systems, provider systems, managed care data, or program integrity tools. * Experience with ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
New
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
New
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Payment integrity (PI) programs Preferred Qualifications Experience with Medicare, Medicaid, and/or Marketplace lines of business. Certified Business Analysis Professional (CBAP) or Certified Coding ...
Data Quality Analyst
Decatur, GA · On-site
Clinical Data Integrity • Analyze service records for completeness, accuracy, and compliance with ... The primary objective is to develop a Standard Operating Procedure (SOP) for each program, which ...
Quick apply
Data Quality Analyst
Decatur, GA · On-site
Clinical Data Integrity • Analyze service records for completeness, accuracy, and compliance with ... The primary objective is to develop a Standard Operating Procedure (SOP) for each program, which ...
... Integrity, and other Client Success staff to execute contractual obligations. The CSP will also ... Understand and continually monitor Federal, state, and local Medicaid School-Based program policies
... Integrity, and other Client Success staff to execute contractual obligations. The CSP will also ... Understand and continually monitor Federal, state, and local Medicaid School-Based program policies
Prepay review of Medicare and Medicaid experience highly desired. * Knowledge of ICD-10 and CPT ... bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision ...
Prepay review of Medicare and Medicaid experience highly desired. * Knowledge of ICD-10 and CPT ... bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision ...
Prepay review of Medicare and Medicaid experience highly desired. * Knowledge of ICD-10 and CPT ... bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision ...
Prepay review of Medicare and Medicaid experience highly desired. * Knowledge of ICD-10 and CPT ... bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision ...
Prepay review of Medicare and Medicaid experience highly desired. * Knowledge of ICD-10 and CPT ... bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision ...
Prepay review of Medicare and Medicaid experience highly desired. * Knowledge of ICD-10 and CPT ... bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision ...
Medicaid Program Integrity information
What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?
| Aspect | Medicaid Program Integrity | Medicaid Claims Examiner |
|---|---|---|
| Primary Focus | Detecting and preventing fraud, waste, and abuse in Medicaid programs | Reviewing and processing Medicaid claims for accuracy and compliance |
| Required Credentials | Typically healthcare or compliance certifications, knowledge of Medicaid policies | Healthcare or claims processing certifications, attention to detail |
| Work Environment | Regulatory agencies, government offices, compliance departments | Insurance companies, healthcare providers, government Medicaid offices |
Medicaid Program Integrity professionals focus on safeguarding Medicaid funds by identifying fraudulent activities, while Medicaid Claims Examiners primarily verify claims for accuracy and proper coding. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work settings.
What are popular job titles related to Medicaid Program Integrity jobs in Georgia? For Medicaid Program Integrity jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Medicaid Program Integrity jobs in Georgia look for? The top searched job categories for Medicaid Program Integrity jobs in Georgia are:
What cities in Georgia are hiring for Medicaid Program Integrity jobs? Cities in Georgia with the most Medicaid Program Integrity job openings:
State Of Georgia rating
7.5
Based on 82 frontline employees who took The Breakroom Quiz
31st of 50 rated states
Job description
Please visit the DCH jobsite link to review the job posting and apply:
If interested, please apply to:
https://www.governmentjobs.com/careers/dchga/jobs/5372195/data-analytics-manager-00056274
Applicants who do not apply using the DCH Jobsite link provided above will NOT be considered.
For other DCH career opportunities,
please visit: https://dch.georgia.gov/dch-employment
The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and Healthcare Facility Regulation, impacting one in four Georgians.
Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and under-served populations. Six enterprise offices support the work of the agency's three program divisions. DCH employees are based in Atlanta, Cordele and across the state.
The Georgia Department of Community Health (DCH) is currently seeking qualified applicants for the position of Data Analytics Manager, in the Office of Inspector General, Program Integrity Unit. The position provides critical support functions within the Program Integrity Unit and the Office of Inspector General, which helps safeguard the agency from fraud, waste, and abuse. The selected candidate will be responsible for managing seven (7) direct reports charged with data reporting and analysis for fraud, waste, and abuse in the Medicaid program. The Data Analytics Manager provides guidance and feedback to the team to ensure adherence to performance metrics and timeliness of business processes for the Program Integrity Unit. The Data Analytics Manager will maintain the Case Management Organization (CMO) dashboard and participate in the Public Assistance Reporting Information System (PARIS) project. The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and onsite utilization reviews. This is a hybrid position that requires in-office and remote work with the approval of your supervisor. Your days of frequency in the office can change at any time during your employment based on the business needs of the organization.
Please visit the DCH jobsite link to review the job posting and apply:
If interested, please apply to:
https://www.governmentjobs.com/careers/dchga/jobs/5372195/data-analytics-manager-00056274
Applicants who do not apply using the DCH Jobsite link provided above will NOT be considered.
For other DCH career opportunities,
please visit: https://dch.georgia.gov/dch-employment
Bachelor's degree in operations management, business administration, or a related field which includes three (3) years in a managerial or supervisory role; or seven (7) years of related professional experience which includes three (3) years in a managerial or supervisory role; or three (3) years of experience required at the lower level Mgr, Business Ops (GSM010) or position equivalent.Note: An equivalent combination of knowledge, education, job or intern experience, training, or certifications that provides the necessary knowledge and skills to successfully perform the job at the level listed may be substituted year-over-year.
If interested, please apply to:
https://www.governmentjobs.com/careers/dchga/jobs/5372195/data-analytics-manager-00056274
Applicants who do not apply using the DCH Jobsite link provided above will NOT be considered.
For other DCH career opportunities,
please visit: https://dch.georgia.gov/dch-employment
The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and Healthcare Facility Regulation, impacting one in four Georgians.
Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and under-served populations. Six enterprise offices support the work of the agency's three program divisions. DCH employees are based in Atlanta, Cordele and across the state.
The Georgia Department of Community Health (DCH) is currently seeking qualified applicants for the position of Data Analytics Manager, in the Office of Inspector General, Program Integrity Unit. The position provides critical support functions within the Program Integrity Unit and the Office of Inspector General, which helps safeguard the agency from fraud, waste, and abuse. The selected candidate will be responsible for managing seven (7) direct reports charged with data reporting and analysis for fraud, waste, and abuse in the Medicaid program. The Data Analytics Manager provides guidance and feedback to the team to ensure adherence to performance metrics and timeliness of business processes for the Program Integrity Unit. The Data Analytics Manager will maintain the Case Management Organization (CMO) dashboard and participate in the Public Assistance Reporting Information System (PARIS) project. The PARIS project is to verify residential requirements for members enrolled in Georgia Medicaid. The desired candidate will collaborate with other Program Integrity staff to facilitate desktop and onsite utilization reviews. This is a hybrid position that requires in-office and remote work with the approval of your supervisor. Your days of frequency in the office can change at any time during your employment based on the business needs of the organization.
Please visit the DCH jobsite link to review the job posting and apply:
If interested, please apply to:
https://www.governmentjobs.com/careers/dchga/jobs/5372195/data-analytics-manager-00056274
Applicants who do not apply using the DCH Jobsite link provided above will NOT be considered.
For other DCH career opportunities,
please visit: https://dch.georgia.gov/dch-employment
Bachelor's degree in operations management, business administration, or a related field which includes three (3) years in a managerial or supervisory role; or seven (7) years of related professional experience which includes three (3) years in a managerial or supervisory role; or three (3) years of experience required at the lower level Mgr, Business Ops (GSM010) or position equivalent.Note: An equivalent combination of knowledge, education, job or intern experience, training, or certifications that provides the necessary knowledge and skills to successfully perform the job at the level listed may be substituted year-over-year.
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