Top 33 Utilization management Jobs in Macon, 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
Outcomes Specialist - Atrium Health Navicent FT
Atrium Health —Macon, GA
- $38.20 - $57.30 an hour
- Full-time
- Mid-level
- 3 years
- Analysis skills
- Paid parental leave
- Disability insurance
Care Manager RN
Atrium Health —Macon, GA
- $41.10 - $61.65 an hour
- Full-time
- Acute care
- Nursing
- RN License
- Paid parental leave
- Paid holidays
Hospitalist Medical Director | Management Bonus Incentive!
Sound Physicians —Macon, GA
- Full-time
- Internal Medicine
- Critical & Intensive Care
- US work authorization
1d
Registered Pharmacist
Medcadre Inc —Gray, GA
- $64 - $68 an hour
- Email
- Mid-level
- High school diploma or GED
- Patient care
- Health insurance
- 401(k)
Quick Apply
5d
Nursing Assistant- 4Main- Nights
Atrium Health —Macon, GA
- $19.80 - $29.70 an hour
- Full-time
- Acute care
- Hospital
- BLS Certification
- Paid parental leave
- Disability insurance
2d
Nursing Assistant - Flex Pool - Day shift
Atrium Health —Macon, GA
- $19.80 - $29.70 an hour
- Full-time
- Float pool
- Hospital
- BLS Certification
- Paid parental leave
- Disability insurance
21h
CMA2 - OB/GYN
Atrium Health —Macon, GA
- Full-time
- CPR Certification
- Vital signs
- BLS Certification
- Paid parental leave
- Disability insurance
3d
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
22h
CMA1 - OB/GYN
Atrium Health —Macon, GA
- Full-time
- CPR Certification
- Vital signs
- BLS Certification
- Paid parental leave
- Disability insurance
3d
Hospitalist Medical Director
Sound Physicians —Macon, GA
- Full-time
- Internal Medicine
- Critical & Intensive Care
- US work authorization
Nurse Director
Atrium Health —Macon, GA
- $68.20 - $102.30 an hour
- Full-time
- Acute care
- CPR Certification
- Nursing
- Paid parental leave
- Disability insurance
Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)
UT Health Science Center at San Antonio —United States
- Hospital
- Outpatient experience
- 3 years
Quick Apply
Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)
Virtix Health —United States
- $125 an hour
- 8 hour shift
- Remote
- Background check
- Medicine
- Doctoral degree
- Work from home
Quick Apply
Complex Care Manager RN-Western MA (Hybrid)
WellSense Health Plan —United States
- $74,000 - $107,000 a year
- Full-time
- Hybrid work
- Background check
- School experience
- Nursing
- Health insurance
- Dental insurance
Inpatient Medical Coding Quality Auditor
Pena4 Inc. —United States
- $80,000 - $90,000 a year
- 8 hour shift
- Remote
- 5 years
- US work authorization
- Senior level
- Health insurance
- Dental insurance
Quick Apply
12d

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Outcomes Specialist - Atrium Health Navicent FT
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Case Manager / PRN ( RN / RT / SW / LPN )
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Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
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utilization management jobs near macon, 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 macon, ga

D107 - C&A MH Crisis - Utilization Management Coordinator

Outcomes Specialist - Atrium Health Navicent FT

Care Manager RN

Hospitalist Medical Director | Management Bonus Incentive!

Registered Pharmacist

Nursing Assistant- 4Main- Nights

Nursing Assistant - Flex Pool - Day shift

CMA2 - OB/GYN

Lead Medical Case Manager / Focal Point

CMA1 - OB/GYN

Hospitalist Medical Director

Nurse Director

Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)

Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)

Complex Care Manager RN-Western MA (Hybrid)

Inpatient Medical Coding Quality Auditor

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