Top 26 Utilization management Jobs in Fort Valley, Ga

D107 - C&A MH Crisis - Utilization Management Coordinator
River Edge Behavioral Heath —Macon, GA
- Full-time
- Psychiatry
- Pass drug screening
- Mid-level
- Paid holidays
- Dental insurance
Emergency Medical Technician-Blue Bird Corporation
OrthoGeorgia —Fort Valley, GA
- $16.54 - $25.65 an hour
- Extended hours
- Blood sampling
- High school
- Customer service
- Health savings account
- Health insurance
Quick Apply
Health Plan Medical Director
TotalMed, Inc. —Georgia
- $125 an hour
- Part-time
- Remote
- Senior level
Quick Apply
2d
Patient Care Coordinator - Advanced Eyecare Center, Perry
TeamVision —Perry, GA
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Health insurance
- Paid time off
Medical Receptionist
Comprehensive Care Medical Offices, LLC —Warner Robins, GA
- From $15 an hour
- Full-time
- Word processing
- Primary Care
- EMR systems
- Paid time off
Quick Apply
9d
Lead Medical Case Manager/ Focal Point - Remote
Essential Healthcare Solutions LLC —Warner Robins, GA
- $27 - $32 an hour
- 8 hour shift
- Anatomy knowledge
- Microsoft Excel
- Microsoft Outlook
- Flextime
Quick Apply
7d
Outcomes Specialist Quality
Atrium Health —Macon, GA
- $38.20 - $57.30 an hour
- Full-time
- Mid-level
- 3 years
- Analysis skills
- Paid parental leave
- Disability insurance
CNA - Atrium Health Peach PRN
Advocate Aurora Health —Byron, GA
- $19.80 - $29.70 an hour
- Part-time
- Hospital
- BLS Certification
- Inpatient
6d
Lead Medical Case Manager / Focal Point
Essential Healthcare Solutions LLC —Warner Robins, GA
- $27 - $32 an hour
- 8 hour shift
- Anatomy knowledge
- Microsoft Excel
- Microsoft Outlook
- Flextime
Quick Apply
CNA - Atrium Health Peach PRN
Atrium Health —Byron, GA
- $19.80 - $29.70 an hour
- Part-time
- Hospital
- BLS Certification
- Inpatient
- Paid parental leave
- Disability insurance
5d
Nursing Assistant | Inpatient Behavioral Health | Nights
Atrium Health —Macon, GA
- $19.80 - $29.70 an hour
- Weekends as needed
- Psychiatry
- BLS Certification
- Inpatient
- Paid parental leave
- Disability insurance
Hospitalist Medical Director
Sound Physicians —Macon, GA
- Full-time
- Internal Medicine
- Critical & Intensive Care
- US work authorization
Home Health RN- Macon
Atrium Health —Macon, GA
- $35.50 - $53.25 an hour
- 8 hour shift
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Disability insurance
12d
Remote Orthopedic Physician (MD/DO) Outpatient Prior Authorizations (IC to FTE)
Virtix Health —United States
- $125 an hour
- 8 hour shift
- Remote
- Background check
- Medicine
- Doctoral degree
- Work from home
Quick Apply

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Quality Assurance Verifier
Perdue Farms Inc —Perry, GA
Worked a minimum of 6 months of consecutive work history with one employer within the past 3 years in a comparable field. Able to stand for several hours.
11d
Data Collector - 3rd Shift
Perdue Farms Inc —Perry, GA
Minimum of 6 months of consecutive work history with one employer within the past 3 years in a comparable field. Perform and record Verification Checks.

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Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
Quick Apply
Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Conducts utilization reviews of behavioral health cases to determine medical necessity…

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utilization management jobs near fort valley, ga

D107 - C&A MH Crisis - Utilization Management Coordinator

River Edge Behavioral Heath -
Macon, GA

Apply Now

Job Details

Full-time

Benefits

Paid holidays
Dental insurance
Flexible spending account
Vision insurance
Life insurance
Retirement plan

Qualifications

High school diploma or GED
Utilization management
Resource utilization in healthcare

Full Job Description

About River Edge Behavioral Health

Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at our Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups.

Utilization Management Coordinator

Company Overview:
At River Edge Behavioral Health in Macon, GA, employees are expected to develop meaningful relationships with patients, establishing trust and making a difference in the lives of clients and their families. We believe in supporting our team as well as our clients with our comprehensive benefits package and a supportive work culture, including health, dental, and vision benefits, paid vacation, retirement plans, and more.

Position Overview:
The Utilization Management Coordinator role is focused on ensuring clients receive the appropriate level of behavioral health care while maintaining compliance with medical necessity, authorization, and documentation requirements. The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services.

Location/Schedule:
3575 Fulton Mill Road, Macon, GA.

Key Responsibilities

Create Connects batch files
Retrieve and process response files from Beacon’s SFTP site
Work Connects documents in rejected, denied, hold, no CID, multi-final payer and status appropriately
Review discharge connects and flip to UM complete
Manage and process BHL CSU authorizations and update Carelogic
Review and process AC file for BHL CSU authorization
Complete State Discharge process for Fulton locations
Create PTRF referral via Beacon authorization request
Review and process Connects documents in UM review

Qualifications

High School Diploma (Bachelors in helping profession such as social work, community counseling, counseling psychology, or criminology preferred)
1-3 years of utilization management experience

Additional Benefits:

Flexible spending accounts
11 Paid holidays
Voluntary Life Insurance

If you are looking for an opportunity to make life better and a strong desire for personal growth we encourage you to apply. We promptly review all applications. Highly qualified candidates will be contacted for interviews.

We are an equal opportunity employer and highly value diversity. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

All selected applicants must pass a satisfactory background clearance and pre-employment drug test.

Apply Now

Refine Your Search

utilization management jobs in fort valley, ga

D107 - C&A MH Crisis - Utilization Management Coordinator

Emergency Medical Technician-Blue Bird Corporation

Health Plan Medical Director

Patient Care Coordinator - Advanced Eyecare Center, Perry

Medical Receptionist

Lead Medical Case Manager/ Focal Point - Remote

Outcomes Specialist Quality

CNA - Atrium Health Peach PRN

Lead Medical Case Manager / Focal Point

CNA - Atrium Health Peach PRN

Nursing Assistant | Inpatient Behavioral Health | Nights

Hospitalist Medical Director

Home Health RN- Macon

Remote Orthopedic Physician (MD/DO) Outpatient Prior Authorizations (IC to FTE)

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