• Contract Build Analyst, Managed Care

    Emory Healthcare/Emory University (Atlanta, GA)
    …+ Emory Healthcare is seeking a Contract Build Analyst to join our Medical Economics team + The Contract Build Analyst role is responsible forimplementing, ... validating, and maintaining contract models within the StrataJazz and EPIC platforms; in addition to supporting strategic initiatives related to payor agreements + Implementation includes configuring user requirements. Validation requires identifying scenarios… more
    Emory Healthcare/Emory University (08/20/25)
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  • Field Care Manager, Ltss (RN) - Local…

    Molina Healthcare (GA)
    …to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our ... & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, Certification,… more
    Molina Healthcare (07/20/25)
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  • Medical Director - Care Plus - Florida

    Humana (Atlanta, GA)
    …clinical specialists with recent inpatient experience preferred** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (06/28/25)
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  • Care Manager (RN)

    Molina Healthcare (Macon, GA)
    …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
    Molina Healthcare (08/27/25)
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  • Supervisor, Care Review (RN) Utilization…

    Molina Healthcare (GA)
    …Health or related field. **Preferred Experience** + 5 years clinical practice with managed care , hospital nursing or utilization management experience. + 3+ ... assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term...years supervisory experience in a managed healthcare environment. + Previous experience… more
    Molina Healthcare (08/20/25)
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  • Care Manager, Ltss (RN)

    Molina Healthcare (GA)
    …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year experience… more
    Molina Healthcare (08/09/25)
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  • RN Care Manager Remote with field travel…

    Molina Healthcare (Columbus, GA)
    …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
    Molina Healthcare (08/08/25)
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  • Telephonic Behavioral Health Care Manager

    Humana (Atlanta, GA)
    …AND/OR Clinical Psychologist (Ph.D.)** . + 3 or more years of clinical or managed care experience. + Experience in managing mental health crisis intervention. + ... community and help us put health first** The Telephonic Care Manager will be part of the Humana Military...for Behavioral Health Case Management throughout the continuum of care . They will have personal interaction with beneficiaries to… more
    Humana (08/29/25)
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  • Care Manager (RN)

    Centene Corporation (Atlanta, GA)
    …We're Looking For: + Registered Nurses with experience in case management, home health, or managed care . + Bedside nursing experience in med surg/acute care . ... reside in the State of Georgia.** **Now Hiring: Remote Care Manager RNs - Join Centene's Ambetter Marketplace Team!**...is expanding our team and currently hiring a Remote Care Manager RNs to support our Ambetter Marketplace members.… more
    Centene Corporation (08/28/25)
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  • Supervisor, Care Management

    Molina Healthcare (Augusta, GA)
    …**Required Experience** 3 or more years in case management, disease management, managed care or medical or behavioral health settings. **Required License, ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
    Molina Healthcare (08/27/25)
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