- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the ... health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and… more
- CVS Health (Atlanta, GA)
- …+ This position may support UM (includes expedited), MPO, Coding, or Behavioral Health appeals. + This is a full-time telework position with standard ... At CVS Health , we're building a world of health...**Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant** to join our remote team. In this… more
- Highmark Health (Atlanta, GA)
- …panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of ... various resources to assist members in achieving their personal health goals. Will work with providers to insure quality...in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and… more
- Molina Healthcare (Atlanta, GA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more