• National Utilization

    Humana (Atlanta, GA)
    **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
    Humana (06/06/25)
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  • Medical Director - Medicaid N. Central

    Humana (Atlanta, GA)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Social Services Director of Care…

    Emory Healthcare/Emory University (Atlanta, GA)
    …all case management activities at the local hospital, including utilization management , transitions of care, discharge planning, payer authorization, medical ... and leadership programs + And more **Description** We are seeking a capable ** Director , Care Management ** who has acquired broad experience in caring for… more
    Emory Healthcare/Emory University (05/08/25)
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  • Medical Director , MSK Surgery

    Evolent (Atlanta, GA)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
    Evolent (05/20/25)
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  • Field Medical Director , Interventional…

    Evolent (Atlanta, GA)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (04/30/25)
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  • Medical Director - Care Plus - Florida

    Humana (Atlanta, GA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (04/24/25)
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  • Director of Rehab

    Genesis Healthcare (Duluth, GA)
    …Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... management of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
    Genesis Healthcare (04/23/25)
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  • Medical Director - Mid West Region

    Humana (Atlanta, GA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Atlanta, GA)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (06/06/25)
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  • Medical Director - OneHome

    Humana (Atlanta, GA)
    …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/31/25)
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  • Field Medical Director , Vascular Surgery

    Evolent (Atlanta, GA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (06/06/25)
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  • Field Medical Director , Cardiology

    Evolent (Atlanta, GA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/16/25)
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  • Regional Field Director , RNS Program…

    United Therapeutics (Atlanta, GA)
    …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
    United Therapeutics (06/05/25)
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  • Capacity & Resource Management

    Grant Thornton (Atlanta, GA)
    …to share strategy, to implement process improvements and to roll out capacity management strategies to maximize utilization and drive operational excellence + ... Grant Thornton is seeking an Advisory Capacity & Resource Management (C&RM) Leader to join the team. Approved office...on yearly budget planning for headcount, gross charge hours, utilization , and leverage. You will lead your team to… more
    Grant Thornton (05/09/25)
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  • Medical Director -Payment Integrity

    Humana (Atlanta, GA)
    …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (06/06/25)
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  • Field Medical Director , Physical Medicine…

    Evolent (Atlanta, GA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Rehab you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/30/25)
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  • Field Medical Director , Oncology

    Evolent (Atlanta, GA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/20/25)
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  • Business Development Senior Director

    CBRE (Atlanta, GA)
    Business Development Senior Director , Enterprise Occupier Solutions Job ID 208590 Posted 28-Feb-2025 Service line GWS Segment Role type Full-time Areas of Interest ... **The client-facing title for this role is Senior Managing Director , Business Development** We are seeking a Senior ...and grow activities in integrated Real Estate and Facilities Management outsourcing pursuits, and will lead interactions in a… more
    CBRE (06/03/25)
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  • Associate University Librarian and Director

    Emory Healthcare/Emory University (Atlanta, GA)
    …Health, the graduate Division of Biological & Biomedical Sciences, the Emory National Primate Research Center, and Emory Healthcare hospitals including components of ... Woodruff Health Sciences Center with reliable and sustainable access to and utilization of data, information and knowledge. Informationists and staff provide a full… more
    Emory Healthcare/Emory University (03/14/25)
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  • Director , Operations

    Zelis (Atlanta, GA)
    …to enhance customer satisfaction, improve efficiency & quality assurance, performance management and achieving business objectives. The successful Director is ... serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs...Position Overview Zelis is seeking a dynamic and experienced Director of Operations to lead our Price Optimization Call… more
    Zelis (05/31/25)
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