- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Humana (Atlanta, GA)
- …such as provider relations, claims submission and payment, utilization management processes, behavioral health processes, and dispute resolution. ... orientation and annual training materials, including materials specific to behavioral health and long-term care providers to...timelines. + Bachelor's degree and 3+ years of project management experience. + 3+ years of Medicaid or contracting… more
- CVS Health (Atlanta, GA)
- …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations… more
- Elevance Health (Atlanta, GA)
- …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... **Be Part of an Extraordinary Team** **Title** : Behavioral Health Clinical Quality Audit Analyst...audits of required documents. Will work within the Quality Management Department and the Georgia Collaborative. Will be responsible… more
- Superior Court of Fulton County (Atlanta, GA)
- PART-TIME BEHAVIORAL HEALTH CLINICIAN II **SUPERIOR COURT OF FULTON COUNTY** **JOB ANNOUNCEMENT FOR THE POSITION OF** PART-TIME BEHAVIORAL HEALTH ... Fulton County Georgia ("Court") has an exciting opportunity for an experienced Behavioral Health Clinician II within its Accountability Court's Division.… more
- Humana (Atlanta, GA)
- …clinical services . Experience in utilization management review and case management in a health plan setting . No current sanction from Federal or ... part of our caring community and help us put health first** The Behavioral Health ...a focus on collaborative business relationships, value-based care, population health , or disease or care management +… more
- Superior Court of Fulton County (Atlanta, GA)
- BEHAVIORAL HEALTH CLINICIAN I **SUPERIOR COURT OF FULTON COUNTY** **JOB ANNOUNCEMENT FOR THE POSITION OF** BEHAVIORAL HEALTH CLINICIAN I **_SALARY GRADE ... Fulton County Georgia ("Court") has an exciting opportunity for an experienced Behavioral Health Clinician within its Accountability Courts Division. Superior… more
- Highmark Health (Atlanta, GA)
- …account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and case/ disease management ... information to improve individual outcomes as an adjunct to health coaching. If acting in the capacity as a...review. + Assist in the development and implementation of utilization management programs including but not limited… more
- Molina Healthcare (Atlanta, GA)
- …**Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM), Certified Professional in Health Care ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- Highmark Health (Atlanta, GA)
- …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more