- Centene Corporation (Atlanta, GA)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …our academic community. **Description** We are seeking an experienced and visionary Senior Administrator to lead the Department of Ophthalmology through a period of ... success in a competitive, rapidly evolving healthcare landscape. The Senior Administrator for Ophthalmology oversees and manages the operational, financial,… more
- Humana (Atlanta, GA)
- …identified gaps. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality ... caring community and help us put health first** The Senior Policy Governance Professional will focus on compliance processes...capacity ie Committees, projects. + 3 or more years' Utilization Management Experience + 2 + years… more
- Molina Healthcare (Macon, GA)
- …years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... cost savings and quality improvement opportunities. + Accounts for regulatory and accreditation performance of assigned team and responds to inquiries, issues and… more
- Evolent (Atlanta, GA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Atlanta, GA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Evolent (Atlanta, GA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Atlanta, GA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Atlanta, GA)
- …Doing:** As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. .… more
- Evolent (Atlanta, GA)
- …Field Medical Director, Physical Medicine and Rehab you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more