- Molina Healthcare (GA)
- …of Georgia. JOB DESCRIPTION Job Summary Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: ... and supports (LTSS), and/or member assessment. * Facilitates integrated, proactive healthcare services management - ensuring compliance with state and federal… more
- Molina Healthcare (GA)
- …Licensure. JOB DESCRIPTION Job Summary Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: ... one or more of the following key health care services functions: care management, utilization management, care...clinical services . * Collaborates with and keeps healthcare services senior leadership informed of operational… more
- CVS Health (Atlanta, GA)
- …promote high-quality healthcare for members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This ... team maintains compliance and privacy practices. + Oversees the implementation of utilization management services for assigned area + Implements clinical… more
- Molina Healthcare (Columbus, GA)
- … utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services /Management staff work to ensure that Molina members...initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and… more
- Molina Healthcare (Macon, GA)
- … Healthcare Effectiveness Data Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Services (CAHPS), and other quality metrics. * ... initiatives under the direction of leadership. * Monitors drug utilization and assists leadership team in understanding quality and...care team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing… more
- Molina Healthcare (Atlanta, GA)
- …to improve member quality of life and to control costs. + Trains healthcare services staff on professional standards of documentation. + Reeducates staff ... State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in… more
- Elevance Health (Atlanta, GA)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Elevance Health (Atlanta, GA)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Molina Healthcare (Augusta, GA)
- …into functional requirements. + Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality ... **Job Summary** Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design,… more
- Molina Healthcare (GA)
- JOB DESCRIPTION **Job Summary** The Supervisor, Healthcare Services UM leads and supervises a multidisciplinary team of healthcare services professionals ... and application of protocols and guidelines. + Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources,… more
- Molina Healthcare (Savannah, GA)
- …reporting requirements and Health Plan project documentation. + Maintains reporting service level benchmarks for Healthcare Analytics team. + Represents ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
- Emory Healthcare/Emory University (Duluth, GA)
- …or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status or any other ... **Overview** **Be inspired** **.** **Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel your professional journey with better benefits,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status or any other ... **Overview** **Be inspired. Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel...resource related issues. + Collaborates closely with call center manager to ensure continuous open communication about clinical operations… more
- Molina Healthcare (Augusta, GA)
- …Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and ... for retrieving specified information from data sources. + Knowledge of healthcare operations ( utilization management, disease management, HEDIS quality measures,… more
- HCA Healthcare (Savannah, GA)
- …University Medical Center which is part of the nation's leading provider of healthcare services , HCA Healthcare . **Benefits** Memorial Health University ... preferred Memorial Health University Medical Center (https://memorialhealth.com/) has provided quality healthcare services since 1955, giving patients access to… more
- HCA Healthcare (Augusta, GA)
- …join Doctors Hospital of Augusta which is a part of the nation's leading provider of healthcare services , HCA Healthcare . Do you want to work where you have ... you have the career opportunities as a RN Case Manager PRN you want in your current role? We... " **Doctors Hospital of Augusta** has provided quality healthcare services since 1973. We give patient's… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status or any other ... **Overview** **Be inspired. Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel...concentrating in 70 different subspecialties. **Description** JOB DESCRIPTION: The Manager , Radiology Quality and Safety plays a crucial role… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …works with the communications team to support business partners across the Emory Healthcare system. + The Internal Communication Manager will work with internal ... materials for targeted audiences that enhance awareness and the utilization of division programs and services +...pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status… more
- HCA Healthcare (Savannah, GA)
- …preferred. Memorial Health University Medical Center (https://memorialhealth.com/) has provided quality healthcare services since 1955, giving patients access to ... invests in you as a Registered Nurse (RN) Case Manager ? At Memorial Health University Medical Center, in the...historic town of Savannah, Georgia, you come first. HCA Healthcare has committed up to $300 million in programs… more
- Grant Thornton (Atlanta, GA)
- …of audit-preparation software and an understanding of how technology impacts healthcare operations. + Exceptional client service , communication, analytical, ... As a Process Risk Experienced Manager , you will have the opportunity to grow...of direct experience with diverse life sciences companies or healthcare providers, including hospitals, academic medical centers, healthcare… more