- Molina Healthcare (Savannah, GA)
- …NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is ... responsible for developing, implementing, and monitoring the success of quality improvement interventions . The Manager works to coordinate resources and… more
- Medtronic (Atlanta, GA)
- …compassionate world. **A Day in the Life** At Medtronic, the Sales Representative II, Pain Interventions is a Senior level role that is considered a clinical and ... alliances. This role reports directly to a District Sales Manager , partners with other Sales Representative peers as well...other Sales Representative peers as well as with a Clinical Specialist team. This is a ** ** **field… more
- Elevance Health (Atlanta, GA)
- … data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals. + Serves as a clinical resource to other pharmacists and ... providers in areas such as prospective, inpatient, and retrospective DURs and clinical support for therapeutic interventions . + Prepares information for network… more
- Sharecare (Atlanta, GA)
- …support in an appropriate, efficient and cost-effective manner while ensuring high quality care. The Clinical Registered Nurse coordinates with the Primary ... total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible… more
- ChenMed (Decatur, GA)
- …indicators. + Fosters growth and effectiveness of Pharmacy work teams to meet quality and clinical care standards/ + Assists Pharmacy leadership in ensuring ... rapidly expanding and we need great people to join our team. The Clinical Pharmacist specializing in Population Health is a skilled and proactive professional who… more
- Highmark Health (Atlanta, GA)
- …referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the delivery of health care services; educates ... and member satisfaction. Responds to customer inquiries and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management… more
- AdventHealth (Calhoun, GA)
- …Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the ... a Family" + Affordable land and homes + Outstanding quality of life + Strong cultural community + Access...and Chattanooga **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- Public Consulting Group (Atlanta, GA)
- …* Document all care activity via case management software system * Promotes quality and cost-effective interventions and outcomes * Assesses and addresses ... a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible...accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes +… more
- Highmark Health (Atlanta, GA)
- …to appropriate multi-disciplinary resources. In addition to identifying the appropriate clinical interventions and referrals, the incumbent will manage an ... performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members… more
- CVS Health (Atlanta, GA)
- …we do it all with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible ... chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress,… more
- Sharecare (Atlanta, GA)
- …2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care Management program ... in an appropriate and efficient manner by providing high- quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with… more
- Molina Healthcare (GA)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Completes clinical assessments of members per regulated timelines and determines who may qualify… more
- BrightSpring Health Services (Atlanta, GA)
- Our Company ResCare Community Living Overview The Program Manager will be responsible for the operation of Therapeutic Foster Care as far as all actions, decisions, ... and performances within the total scope of the treatment program. The Program Manager will also be responsible for developing, implementing, and managing the foster… more
- State of Georgia (Dekalb County, GA)
- Case Manager - Child & Adolescent Georgia - Dekalb - Decatur (https://careers.georgia.gov/jobs/64300/other-jobs-matching/location-only) Social Services ... Job Sign Up for Job Alerts JOB SUMMARY: The Child & Adolescent Case Manager /Community Support Individual (CSI) is an integral part of the Child & Adolescent Program,… more
- Healthfirst (GA)
- …and medical necessity of treatments and service utilizations based on clinical documentation, regulatory, and InterQual/MCG criteria + Assessment - identifying ... and recovery + Documenting - documenting all determinations, notifications, interventions , and telephone encounters in accordance with established documentation… more
- Healthfirst (GA)
- …ensure the best individualized care decisions, adherence to timely assessments and interventions for each members changing condition(s) + Build a high performing ... team where clinical , technical and leadership skills are developed and assessed...in the members electronic record. + Participate in the Quality Management Program, identifying performance/process improvement opportunities and recommend… more
- Molina Healthcare (GA)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified… more
- Molina Healthcare (GA)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. + Promotes integration… more
- Molina Healthcare (GA)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. + Promotes integration… more
- Public Consulting Group (Atlanta, GA)
- …complete accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes + Assesses and ... informed decisions by acting as their advocate regarding their clinical status and treatment options + Develops effective working...management, including as a nurse, medical, mental health care manager or a related job + Excellent knowledge of… more