• UM Case Manager

    Healthfirst (GA)
    …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... **This position is 100% Remote **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
    Healthfirst (05/08/25)
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  • Transplant Care Nurse RN - Stem Cell, Bone Marrow…

    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
    Highmark Health (04/25/25)
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  • Behavioral Health Care Manager I - PASRR…

    Elevance Health (Savannah, GA)
    **Behavioral Health Care Manager I** **Location:** **Georgia.** Virtual: This role enables associates to work virtually full-time, with the exception of required ... and ensures essential face-to-face onboarding and skill development. The **BH Care Manager I** is responsible for managing psychiatric and substance abuse or… more
    Elevance Health (05/14/25)
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  • Manager , Care Management LTC

    Healthfirst (GA)
    …with demonstrated ability to handling rapidly changing crisis situations + Knowledge of UM /QM case philosophies and reporting requirements to state and federal ... agencies + Ability to allocate, monitor, and control resources while delegating and monitoring workloads + Ability to effectively manage performance as well as set and achieve goals **Compliance & Regulatory Responsibilities:** + Ensures Care Management team… more
    Healthfirst (05/07/25)
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  • Family Health Advocate - Remote

    Sharecare (Atlanta, GA)
    …hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management ( UM ) status, including but not limited to medical, dental, and vision ... members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are not limited to: +… more
    Sharecare (04/12/25)
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