- CVS Health (Atlanta, GA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Atlanta, GA)
- …all with heart, each and every day. **Position Summary** Medicare Predetermination Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
- CVS Health (Atlanta, GA)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- CVS Health (Atlanta, GA)
- …of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare ... knowledge and expertise to enhance their understanding of utilization management principles and improve their clinical decision-making. Contributes to the… more
- Highmark Health (Atlanta, GA)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- CenterWell (Atlanta, GA)
- …on wellness, prevention, and early detection. The PL is responsible for executing the clinical strategy through the management of their own patient panel as well ... management + Providing direct education to clinicians around clinical protocols / disease + prevalence / appropriate levels...+ Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …a central role in this transition - leading facility design, ensuring effective utilization of clinical spaces, and executing the planned relocation initiative ... basis. This individual is a content expert and internal consultant for physician leadership and clinical faculty,...Management : + Has responsibility for both academic and clinical missions. + Working with Chair and SOM Compensation… more
- Elevance Health (Atlanta, GA)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May...an entire clinical program and/or independently performs clinical reviews. + Typically has program management … more
- State of Georgia (Dekalb County, GA)
- …interventions to improve the student's disciplinary and academic performance + Serves as clinical consultant for school staff and may assist educators with ... an evidence-based framework within the school environment. Demonstrates strong clinical judgment in assessment, application of diagnostic criteria, clinical… more