- CVS Health (Atlanta, GA)
- …Under the direction of the Lead Clinical Psychologist, this position will focus on utilization , quality, and review of fraud, waste, and abuse for individual ... with heart, each and every day. **This is full-time, remote position. Candidates can reside anywhere in the US...Aetna member cases. **Expectations/Responsibilities:** + Review and prepare cases for medical necessity … more
- Kemper (Alpharetta, GA)
- Location(s) Remote -AL, Remote -CT, Remote -FL, Remote -GA, Remote -IL, Remote -IN, Remote -MI, Remote -NC, Remote -OH, Remote -PA, ... complex technical problems and issues with assigned applications and work processes. + Review and recommend test plans for impacted areas and end to end test… more
- CVS Health (Atlanta, GA)
- …And we do it all with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may vary based on business needs) ... level. The Associate Manager is also responsible for oversight of utilization management nurses including the organization and development of high performing… more
- Fujifilm (Atlanta, GA)
- …identifying activities, sponsorships, and equipment needed to ensure success. + Review and consideration of event participation levels and requirements, involving ... key stakeholders as needed, and share with review committee for consideration. + Timely, proactive sharing and...data monitoring, analysis, summary, and report generation for sales utilization of Showpad materials and platform, including areas of… more
- Humana (Atlanta, GA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Centene Corporation (Atlanta, GA)
- …including a fresh perspective on workplace flexibility. **Centene is hiring a Remote Psychologist - Join Our Medicaid Team!** **Are you a licensed Psychologist ... a passion for improving access to behavioral health care? Centene is looking for a Remote Psychologist to support our Medicaid plan. In this role, you'll play a key… more
- Humana (Atlanta, GA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to influence department's… more
- Humana (Atlanta, GA)
- …for requested services using clinical judgment and refers to internal stakeholders for review depending on case findings. + Educates providers on utilization and ... and ability to troubleshoot and resolve basic technical difficulties in a remote environment + Ability to work independently under general instructions and with… more
- Arrow Electronics (Loganville, GA)
- …design, product and proof of concept demonstrations, solution consultation, architecture review , and enablement of Arrow partners. The SED possesses a background ... Solutions Lab as a key differentiator for Arrow. Drive utilization through technology demonstrations, POCs, and innovation tied to...to assist in closing a deal. **Work Arrangement:** Fully Remote : Must be able to travel to an Arrow… more
- Humana (Atlanta, GA)
- …and leadership during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy ... develop and maintain medical coverage policies utilizing an evidence based medicine review process. **Location:** work at home anywhere Humana is seeking a Senior… more