• Product Manager - Utilization…

    Highmark Health (Atlanta, GA)
    …ability to deliver engaging and informative product demonstrations and walkthroughs. + ** Utilization Management & Clinical Expertise:** + Utilization ... Knowledge: Familiarity with medical terminology, healthcare delivery systems, and clinical guidelines relevant to utilization management. + Healthcare Industry… more
    Highmark Health (07/12/25)
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  • Pharmacist, Utilization Management (UM)

    Molina Healthcare (Augusta, GA)
    …by the Manager . + Identifies and implements programs to improve clinical outcomes stemming from medication selection, utilization , and adherence. **JOB ... management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy… more
    Molina Healthcare (07/27/25)
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  • Utilization Management Representative I

    Elevance Health (Columbus, GA)
    ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ " The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
    Elevance Health (07/29/25)
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  • RN Clinical Manager , Home Health

    CenterWell (Marietta, GA)
    **Become a part of our caring community and help us put health first** The Clinical Manager , Home Health Nursing enables patients to stay in their homes by ... providing health and personal services; supporting patients and their families. The Clinical Manager , Home Health Nursing works within specific guidelines and… more
    CenterWell (07/25/25)
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  • Dialysis Clinical Manager Registered…

    Fresenius Medical Center (Decatur, GA)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... functions, leading your business, and advanced leadership. As a Clinical Manager , you may advance your career...Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
    Fresenius Medical Center (07/29/25)
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  • Lead Product Manager - Clinical…

    Humana (Atlanta, GA)
    …help us put health first** We're seeking a strategic, results-driven Lead Product Manager to design and deliver innovative clinical solutions that improve health ... delivery with a focus on scalable digital and non-digital clinical solutions. You'll sit at the center of product,...product success metrics including market adoption, customer satisfaction, and utilization ​ + Serve as a leader on the… more
    Humana (07/18/25)
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  • Dialysis Clinical Manager Registered…

    Fresenius Medical Center (Lithonia, GA)
    …the delivery of maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
    Fresenius Medical Center (06/14/25)
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  • Clinical Account Manager - Georgia…

    Prime Therapeutics (Atlanta, GA)
    …It fuels our passion and drives every decision we make. **Job Posting Title** Clinical Account Manager - Georgia PDL - Remote **Job Description** Innovative ... with pharmacy department or designated customer contacts. + Directs operations account manager in resolving customer service issues and actions supportive of the… more
    Prime Therapeutics (07/24/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (GA)
    …Officer during Fair Hearings as may be required. + Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and ... home office with internet connectivity of high speed required._ **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical … more
    Molina Healthcare (07/20/25)
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  • Supervisor, Clinical Pharmacy/MTM - Remote

    Molina Healthcare (Savannah, GA)
    …management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy ... medications safety and medication use policies). **Knowledge/Skills/Abilities** The Supervisor, Clinical Pharmacy/Medication Therapy Management (MTM) supervises Pharmacists, Pharmacist Interns,… more
    Molina Healthcare (07/09/25)
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