• Pharmacy Quality Assurance Specialist

    Elevance Health (Atlanta, GA)
    Carelon is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new ... the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How… more
    Elevance Health (08/29/25)
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  • Utilization Management Representative I

    Elevance Health (Atlanta, GA)
    …make an impact:** + Managing incoming calls or incoming post services claims work. + Determines contract and benefit eligibility; provides authorization for ... Locations: New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,...laws. * The salary range is the range Elevance Health in good faith believes is the range of… more
    Elevance Health (08/29/25)
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  • Actuarial Analyst II

    Elevance Health (Atlanta, GA)
    …and models data including risk reporting and forecasting. + Calculates monthly claims liability reserves, develops merit rating factors and prepares Department of ... which would provide an equivalent background. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed… more
    Elevance Health (08/29/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Atlanta, GA)
    …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. **How you ... + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
    Elevance Health (08/28/25)
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  • Transition of Care Associate, Licensed Practical…

    CVS Health (Atlanta, GA)
    At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...advocate for themselves. The TOC team will review prior claims to address potential impact on current case management… more
    CVS Health (08/28/25)
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  • Financial Operations Recovery Process Specialist

    Elevance Health (Columbus, GA)
    …experience strongly preferred. + Previous experience in high-volume operations ( claims , customer service, enrollment and billing) strongly preferred. For candidates ... $115,215.36 Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,...laws. * The salary range is the range Elevance Health in good faith believes is the range of… more
    Elevance Health (08/28/25)
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  • Nurse Case Manager II

    Elevance Health (Atlanta, GA)
    …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site ... + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
    Elevance Health (08/27/25)
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  • Application Architect Senior - Payment Integrity

    Elevance Health (Atlanta, GA)
    …Skills, Capabilities, and Experiences:** + Healthcare experience preferred; medical claims experience a plus. + Extensive hands-on product development experience. ... experience (AWS , GCP). Please be advised that Elevance Health only accepts resumes for compensation from agencies that...from agencies that have a signed agreement with Elevance Health . Any unsolicited resumes, including those submitted to hiring… more
    Elevance Health (08/26/25)
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  • Business Information Consultant Senior - Provider…

    Elevance Health (Atlanta, GA)
    …impact on existing programs. + Conduct comprehensive analysis of healthcare data, claims , and financial reports to identify trends, patterns, and opportunities for ... persuasion preferred. + Deep knowledge of value-based care and/or population health management. + Progressive experience leading and performing analytical work… more
    Elevance Health (08/26/25)
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  • Nurse Case Manager I

    Elevance Health (Columbus, GA)
    …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Perform duties telephonically or on-site ... will make an impact:** + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs and a specific care… more
    Elevance Health (08/26/25)
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