• Lead Trainer - Clinical Services (Remote in GA)

    Molina Healthcare (Savannah, GA)
    …+ 3 or more years in case, disease or utilization management; managed care; or medical/ behavioral health settings. + 3 or more years in a training, auditing ... years in case, disease or utilization management; managed care; or medical/ behavioral health settings. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** :… more
    Molina Healthcare (10/30/25)
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  • Utilization Management Representative I

    Elevance Health (Atlanta, GA)
    …Medical terminology training and experience in medical or insurance field preferred. + Behavioral Health related knowledge is preferred. + For URAC accredited ... identification and data entry of referral requests into the UM system in accordance with the plan certificate. +...areas, the following professional competencies apply: Associates in this role are expected… more
    Elevance Health (11/05/25)
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  • Medical Director-PSCCR

    Elevance Health (Atlanta, GA)
    …The **Medical Director-PSCCR** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes. + Identifies and develops opportunities… more
    Elevance Health (11/05/25)
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  • Care Manager RN - (Remote)

    Highmark Health (Atlanta, GA)
    …effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource ... utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and… more
    Highmark Health (10/22/25)
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