• Manager , Healthcare Services

    Molina Healthcare (GA)
    …of Georgia. JOB DESCRIPTION Job Summary Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: ... and supports (LTSS), and/or member assessment. * Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal… more
    Molina Healthcare (09/19/25)
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  • Director, Healthcare Services

    Molina Healthcare (GA)
    …Licensure. JOB DESCRIPTION Job Summary Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: ... one or more of the following key health care services functions: care management, utilization management, care...clinical services . * Collaborates with and keeps healthcare services senior leadership informed of operational… more
    Molina Healthcare (09/19/25)
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  • RN, Manager , Utilization Management…

    Humana (Atlanta, GA)
    …of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific guidelines and ... caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization...our customers and our company. Through our Humana insurance services and CenterWell healthcare services ,… more
    Humana (09/28/25)
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  • Pharmacist, Utilization Management (UM)…

    Molina Healthcare (Augusta, GA)
    utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services /Management staff work to ensure that Molina members...initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and… more
    Molina Healthcare (09/25/25)
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  • Clinical Learning Facilitator - Utilization

    Molina Healthcare (Atlanta, GA)
    …to improve member quality of life and to control costs. + Trains healthcare services staff on professional standards of documentation. + Reeducates staff ... State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in… more
    Molina Healthcare (09/17/25)
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  • RN UM Supervisor, Healthcare

    Molina Healthcare (GA)
    JOB DESCRIPTION **Job Summary** The Supervisor, Healthcare Services UM leads and supervises a multidisciplinary team of healthcare services professionals ... and application of protocols and guidelines. + Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources,… more
    Molina Healthcare (09/26/25)
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  • Manager , Healthcare Analytics…

    Molina Healthcare (Savannah, GA)
    …reporting requirements and Health Plan project documentation. + Maintains reporting service level benchmarks for Healthcare Analytics team. + Represents ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
    Molina Healthcare (10/04/25)
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  • Care Manager Registered Nurse / RN

    Emory Healthcare/Emory University (Duluth, GA)
    …or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status or any other ... **Overview** **Be inspired** **.** **Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel your professional journey with better benefits,… more
    Emory Healthcare/Emory University (10/02/25)
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  • Manager , Medical Economics (Medicaid)…

    Molina Healthcare (Augusta, GA)
    …Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and ... for retrieving specified information from data sources. + Knowledge of healthcare operations ( utilization management, disease management, HEDIS quality measures,… more
    Molina Healthcare (08/27/25)
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  • Manager Case Management

    HCA Healthcare (Savannah, GA)
    …University Medical Center which is part of the nation's leading provider of healthcare services , HCA Healthcare . **Benefits** Memorial Health University ... preferred Memorial Health University Medical Center (https://memorialhealth.com/) has provided quality healthcare services since 1955, giving patients access to… more
    HCA Healthcare (09/23/25)
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