Top 2952 Quality development associate Jobs in Atlanta, Ga

Utilization Specialist
RiverWoods Behavioral Health —Riverdale, GA
- Part-time
- CPR Certification
- Nursing
- RN License
QA Technician - 2nd shift
Chairmans Foods —Atlanta, GA
- $19.50 an hour
- Weekends as needed
- Microsoft Outlook
- Ability to walk for extended periods
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Entry-Level Marketing Position
HCP Concierge —Atlanta, GA
- $43,000 a year
- Clean driving record
- Customer service
- Administrative experience
- Health insurance
- Dental insurance
Quick Apply
Talent Outreach Coordinator
TELUS Digital —Atlanta, GA
- $25 an hour
- Full-time
- Hybrid work
- Background check
- Customer service
- Word processing
- Health insurance
- Dental insurance
Quick Apply
Food & Nutrition Associate
Emory Healthcare —Atlanta, GA
- $18.00 - $21.93 an hour
- Full-time
- Hospital
- Customer service
- Computer literacy
- Wellness program
- Health insurance
Specimen Processor
Children's Healthcare of Atlanta —Atlanta, GA
- Part-time
- Outpatient experience
- High school diploma or GED
- Children
Quick Apply
9d
Registration Associate
Children's Healthcare of Atlanta —Atlanta, GA
- Part-time
- Microsoft Word
- Basic math
- Office
- On-the-job training
Quick Apply
Registration Associate - PRN
Children's Healthcare of Atlanta —Atlanta, GA
- Part-time
- Microsoft Word
- Basic math
- Windows
- On-the-job training
Quick Apply
Full Time Warehouse Associate
Caterpillar —Atlanta, GA
- $20.00 - $24.90 an hour
- Overtime
- Background check
- 18 years or older
- Basic math
- Health savings account
- Paid holidays
3d
Retail Associate - Lennox
Aritzia —Atlanta, GA
- $20 - $30 an hour
- Part-time
- Merchandising
- Entry level
Junior Operations Associate
Lime —Atlanta, GA
- $28 an hour
- Full-time
- Background check
- Clean driving record
- Inventory management
Quick Apply
Registration Associate (PRN)
Children's Healthcare of Atlanta —Atlanta, GA
- Part-time
- Microsoft Word
- Basic math
- Office
- On-the-job training
Quick Apply
Data Entry Specialist
XpresCheck —Atlanta, GA
- $20 an hour
- Weekends as needed
- Microsoft Outlook
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
8d
Public Health Specialist
XpresCheck —Atlanta, GA
- $25 an hour
- Weekends as needed
- Bilingual
- HIPAA
- Laboratory experience
- Health insurance
- Dental insurance
Quick Apply
8d
Store Associate - (RT0587)
RaceTrac —East Point, GA
- Up to $15.50 an hour
- Full-time
- High school diploma or GED
- Ability to lift 50 pounds
- Entry level
- Opportunities for advancement
Quick Apply
Behavioral Support Aide
Atlanta Youth Services —Atlanta, GA
- $20 an hour
- Overnight shift
- Background check
- 18 years or older
- HIPAA
- Flexible schedule
Quick Apply
10d
Quality Auditor Level I
Clayens US LLC —Atlanta, GA
- $18 - $25 an hour
- Full-time
- High school diploma or GED
- Computer skills
- Associate's degree
Quick Apply
Store Associate - (RT2324)
RaceTrac —College Park, GA
- Up to $15.50 an hour
- Full-time
- High school diploma or GED
- Ability to lift 50 pounds
- Entry level
- Opportunities for advancement
Quick Apply
Patient Access Representative
Emory Healthcare —Atlanta, GA
- $18.90 - $23.03 an hour
- Full-time
- Hospital
- Mid-level
- High school diploma or GED
- Wellness program
- Health insurance
9d
ORDER FULFILLMENT ASSOCIATE I
GLOCK —Smyrna, GA
- Overtime
- Computer literacy
- Office
- High school diploma or GED
Quick Apply
9d

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quality development associate jobs near atlanta, ga

Utilization Specialist

RiverWoods Behavioral Health -
Riverdale, GA

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Job Details

Part-time

Qualifications

CPR Certification
BLS Certification
High school diploma or GED

Full Job Description

Overview:

PURPOSE STATEMENT:

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.

Responsibilities:

ESSENTIAL FUNCTIONS:

Act as liaison between managed care organizations and the facility professional clinical staff.
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
Conduct quality reviews for medical necessity and services provided.
Facilitate peer review calls between facility and external organizations.
Initiate and complete the formal appeal process for denied admissions or continued stay.
Assist the admissions department with pre-certifications of care.
Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

OTHER FUNCTIONS:

Perform other functions and tasks as assigned.

Qualifications:

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

Required Education: High school diploma or equivalent.
Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.

ADDITIONAL REGULATORY REQUIREMENTS:

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

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Refine Your Search

quality development associate jobs in atlanta, ga

Utilization Specialist

QA Technician - 2nd shift

Entry-Level Marketing Position

Talent Outreach Coordinator

Food & Nutrition Associate

Specimen Processor

Registration Associate

Registration Associate - PRN

Full Time Warehouse Associate

Retail Associate - Lennox

Junior Operations Associate

Registration Associate (PRN)

Data Entry Specialist

Public Health Specialist

Store Associate - (RT0587)

Behavioral Support Aide

Quality Auditor Level I

Store Associate - (RT2324)

Patient Access Representative

ORDER FULFILLMENT ASSOCIATE I

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