• Utilization Review Clinician

    Centene Corporation (Atlanta, GA)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
    Centene Corporation (10/10/25)
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  • Care Review Clinician , PA (RN)

    Molina Healthcare (Macon, GA)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
    Molina Healthcare (10/26/25)
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  • Associate Operations Director

    CenterWell (Woodstock, GA)
    …planning, determining services, providers, and expected outcomes collaboratively. *Focus on utilization management and review provider schedules to meet patient ... Google reviews. *Ensure high levels of patient satisfaction by addressing clinician performance issues and fostering a patient-centric environment and culture of… more
    CenterWell (10/28/25)
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