- Humana (Atlanta, GA)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
- Molina Healthcare (Columbus, GA)
- …continuous quality improvement of the provider database, compliance with regulatory/ accreditation requirements, and Network Management business operations. ... improvement initiatives as it pertains to other provider network management areas. **KNOWLEDGE/SKILLS/ABILITIES** + Bridge communication and collaboration between… 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
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
- Elevance Health (Atlanta, GA)
- …Senior Leadership Teams in the areas of medical provider relations, quality management , utilization management , clinical systems design, and clinical ... the state employed. **Preferred Skills, Capabilities and Experiences** + **Leadership & Utilization Management :** Prior leadership role in a managed care… 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)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …& Duties** Leadership & Administration + Serves as a member of the Libraries' senior management group and works in collaboration with senior ... Woodruff Health Sciences Center with reliable and sustainable access to and utilization of data, information and knowledge. Informationists and staff provide a full… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …optimize patient care and service efficiency. 2. Ensure cost-effective resource utilization and monitor functional unit nursing budgets. 3. Standardize policies, ... health system. 4. Foster collaboration between entities to maintain accreditation , certification, and high-performance recognition. Quality, Safety & Compliance: 1.… more