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Remote Case Management Processor Jobs in Georgia

The Forge Companies

Case Manager

Alpharetta, GA · On-site +1

$19.50 - $25.25/hr

Flag and escalate potential risks or discrepancies to management. * Process repayments according to ... This role will be fully remote or hybrid in Alpharetta, GA (preferred) #LI-AR

The Forge Companies

Case Manager

Alpharetta, GA · On-site +1

$18.75 - $24.25/hr

Flag and escalate potential risks or discrepancies to management. * Process repayments according to ... This role will be fully remote or hybrid in Alpharetta, GA (preferred) #LI-AR

CVS Health

Case Manager, Registered Nurse

Atlanta, GA · Remote

$54K - $155K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilizes case management processes in compliance with regulatory and company policies and ...

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Remote Case Management Processor information

What is the difference between Remote Case Management Processor vs Remote Claims Processor?

AspectRemote Case Management ProcessorRemote Claims Processor
CredentialsTypically requires case management certifications or healthcare-related credentialsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare or social services settings, remote or office-basedInsurance companies, healthcare providers, remote or office-based
Industry UsageHealthcare, social services, insuranceInsurance, healthcare, financial services
Job FocusManaging patient or client cases, coordinating servicesProcessing insurance claims, verifying coverage

While both roles involve processing information remotely, the Remote Case Management Processor focuses on managing client cases and coordinating services, often in healthcare or social services. In contrast, the Remote Claims Processor primarily handles insurance claims, verifying coverage and processing payments. Understanding these differences helps job seekers identify the right role based on their credentials and career interests.

What cities in Georgia are hiring for Remote Case Management Processor jobs? Cities in Georgia with the most Remote Case Management Processor job openings:
Remote Case Management Processor jobs near you

Case Management Pharmacist (Remote)

Pharmacy Careers

Lawrenceville, GA • On-site, Remote

Other

Posted 16 days ago

Job description

Case Management Pharmacist - Coordinate Care and Improve Patient Outcomes
A confidential managed care organization is hiring a detail-oriented Case Management Pharmacist to support patients with complex medication needs. This role focuses on coordinating care, preventing medication-related issues, and ensuring members receive the most appropriate therapy at the right time.
Key Responsibilities

  • Collaborate with physicians, nurses, and care coordinators to manage high-risk or complex patients.
  • Conduct medication reviews to identify gaps in therapy, adherence concerns, or potential drug interactions.
  • Support prior authorization and appeals processes when needed.
  • Educate patients and caregivers on medication regimens and disease state management.
  • Document case activities and outcomes in compliance with health plan and regulatory standards.
  • Participate in quality improvement initiatives to reduce hospitalizations and improve health outcomes.


What You'll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Case management, MTM, or managed care experience preferred - retail and hospital pharmacists with strong patient counseling backgrounds are encouraged to apply.
  • Skills: Strong communication, problem-solving, and care coordination skills.


Why This Role?

  • Impact: Make a meaningful difference in patients' lives by ensuring safe and effective medication use.
  • Growth: Develop expertise in case management and managed care pharmacy.
  • Flexibility: Many organizations offer hybrid or fully remote work options.
  • Rewards: Competitive pay, benefits, and career advancement opportunities.

About Us
We are a confidential healthcare partner serving health plans and provider networks nationwide. Our case management pharmacists play a vital role in improving outcomes, reducing readmissions, and supporting patients across the continuum of care.
Apply Today
Apply now for our Case Management Pharmacist opportunity and join a team dedicated to patient-centered, coordinated care.

Apply