- 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
- CenterWell (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … 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
- Humana (Atlanta, GA)
- …of contact for the beneficiary for all activities within the medical and behavioral health spectrum. They will also coordinate with other Medical Management ... part of our caring community and help us put health first** The Telephonic Nurse Case Manager...(SDOH). Plan shall include psychosocial issues, home environment and behavioral health needs across the full continuum… 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