- Healthfirst (GA)
- … management, identifying alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge ... This position is 100% Remote** **Duties//Responsibilities:** + **Provides case management services for assigned member caseloads which includes:** +… more
- Molina Healthcare (Columbus, GA)
- …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
- Molina Healthcare (GA)
- …The license must be active and unrestricted in state of practice. Certified Case Manager (CCM), Certified Professional in Health Care Management certification ... JOB DESCRIPTION **Job Summary** The Supervisor, Healthcare Services UM leads and supervises a multidisciplinary team of...Georgia RN licensure and at least 3 years of UM experience. The candidate must have strong organization, communication,… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Telephonic Nurse Case Manager will be a member of the In-Home Case Management Team, ... case management throughout the continuum of care. The case manager will offer guidance, support, and...Management programs (DM/PN) as needed, in addition to MTF UM / CM staff, physicians and providers as necessary;… more
- Elevance Health (Atlanta, GA)
- **Behavioral Health - Care Manager II** **Location** : _Virtual:_ This role enables associate to work virtually full-time, with the exception of required in-person ... as required by law. The **Behavioral Health - Care Manager II** is responsible for managing psychiatric and substance...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- Elevance Health (Atlanta, GA)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental ... **some weekends based upon organizational/business needs.** The **Behavioral Health Care Manager II** is responsible for managing psychiatric and substance abuse or… more
- Highmark Health (Atlanta, GA)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Highmark Health (Atlanta, GA)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- Sharecare (Atlanta, GA)
- …days of training. PTO needs during the training period will be evaluated on a case by case basis and must be approved in advance._ **Compensation:** $22.00/hour ... hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management ( UM ) status, including but not limited to medical, dental, and vision… more
Recent Jobs
-
Student Worker - Catering - The College of William and Mary
- ARAMARK (Williamsburg, VA)
-
Program Manager, Facilities IV, Energy Management
- Sutter Health (Sacramento, CA)
-
Flight Sciences Hypersonic Thermal Engineer
- Lockheed Martin (Huntsville, AL)
-
Group Sales/Catering Supervisor
- Compass Group, North America (Miami, FL)