• Director , Healthcare Services;…

    Molina Healthcare (GA)
    …of healthcare services professionals in some or all of the following functions: utilization management , care management , behavioral health and other ... one or more of the following key health care services functions: care management , utilization management , care transitions, long-term supports and services… more
    Molina Healthcare (09/19/25)
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  • National Accounts Medical Director

    Elevance Health (Columbus, GA)
    …members. The medical director provides clinical expertise in all aspects of utilization review and case management . Provides input on the clinical ... clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case more
    Elevance Health (09/23/25)
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  • Medical Director - Medicaid N. Central

    Humana (Atlanta, GA)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of… more
    Humana (10/25/25)
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  • Medical Director - Medicaid Team - FL/SC

    Humana (Atlanta, GA)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (10/28/25)
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  • RN or LMSW Manager Case Management

    HCA Healthcare (Savannah, GA)
    …and Qualifications** The Manager Case Management reports to the Case Management Director and is responsible for promoting patient-centered care ... Do you have the career opportunities as a **Manager Case Management ** you want with your current...supporting a balance of optimal care and appropriate resource utilization . **What qualifications you will need:** + Bachelor's Degree… more
    HCA Healthcare (09/23/25)
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  • Medical Director - Mid West Region

    Humana (Atlanta, GA)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (09/16/25)
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  • Director of Rehab - Occupational Therapist…

    Genesis Healthcare (Palmetto, GA)
    …of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification ... Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and… more
    Genesis Healthcare (10/22/25)
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  • Field Medical Director , Interventional…

    Evolent (Atlanta, GA)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (07/30/25)
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  • Medical Director , Medical…

    Highmark Health (Atlanta, GA)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
    Highmark Health (10/28/25)
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  • Medical Director , Behavioral Health…

    Molina Healthcare (Augusta, GA)
    …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case ...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
    Molina Healthcare (10/17/25)
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