- Humana (Atlanta, GA)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
- CVS Health (Atlanta, GA)
- …expense reimbursement policy. Preferred Qualifications : Oklahoma residency preferred Oklahoma-licensed registered nurse preferred OR be certified as a Certified ... a variety of external and internal audiences including senior management . Required Qualifications : * 5 to 7 years'...(CHCQM) by the American Board of Quality Assurance and Utilization Review Providers prior to employment. A minimum of… more
- Highmark Health (Atlanta, GA)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Elevance Health (Atlanta, GA)
- …**telephonic or face-to-face assessments for the identification, evaluation, coordination and management of members needs, including physical health, behavioral ... Care Coordinator Clinician - LPN/LVN, LSW, LCSW, or LMSW** **Carelon Medical Benefits Management ** **Location:** The ideal candidate will live within 50 miles of one… more
- Morehouse School Of Medicine (Atlanta, GA)
- …long-term stages of illness for defined patient populations. This includes utilization management , transitional care planning, psychosocial and functional status ... Summary The Care Coordinator's primary responsibilities are to facilitate care management and coordination of clinical activities for chronically ill patients. The… more