- CVS Health (Atlanta, GA)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide ... clinical insight into product development and testing as well...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CVS Health (Atlanta, GA)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… more
- Cardinal Health (Atlanta, GA)
- **Ideal candidate will live near a major/regional airport.** **_What Clinical Operations contributes to Cardinal Health_** Clinical Operations is responsible for ... and service education to facilitate technology adoption and workflow change management . + Demonstrates extensive knowledge and understanding of relevant clinical… more
- Elevance Health (Atlanta, GA)
- ** Utilization Management Medical Director- NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... Alternate locations may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May be… more
- Highmark Health (Atlanta, GA)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… 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