- Molina Healthcare (Atlanta, GA)
- …changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports ( LTSS ) and home and ... of experience working with persons with disabilities/chronic conditions long-term services and supports ( LTSS ), and 1 year of experience in care management, or… more
- Molina Healthcare (Atlanta, GA)
- …services and supports ( LTSS ) issues. * Identifies and reports quality of care issues. * Prepares and presents cases in conjunction with the chief medical officer ... guidelines. Assesses appropriateness of services, length of stay and level of care provided to members. Contributes to overarching strategy to provide quality and… more
- Molina Healthcare (Atlanta, GA)
- …and supports ( LTSS ) issues. + Identifies and reports quality of care issues. + Assists with complex claim review including diagnosis-related group (DRG) ... to overarching strategy to provide quality and cost-effective member care . **ESSENTIAL JOB DUTIES:** + Facilitates clinical/medical reviews of retrospective… more
- Elevance Health (Atlanta, GA)
- …**Preferred Skills, Capabilities, and Experiences:** + Understanding of managed care or Medicaid/Medicare strongly preferred. + Previous experience in healthcare ... with authorizations is preferred. + Previous experience working with LTSS members or Medicaid is strongly preferred. For URAC...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more