- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION Job Summary The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible for ... experience. Candidates with MCO experience are highly preferred. The Care Review Clinician must be...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Atlanta, GA)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Atlanta, GA)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Atlanta, GA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... emergency room. Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Atlanta, GA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- Molina Healthcare (Atlanta, GA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Emory Healthcare/Emory University (Decatur, GA)
- …**Unit Charge, Critical Care Stepdown LTAC** responsible for being a capable clinician who has acquired broad experience in caring for patients and has developed ... a sound understanding about the care of a particular patient population and routinely uses...experience to respond to changes in clinical situations. This RN professional is able to apply the Synergy Model… more
- Centene Corporation (Atlanta, GA)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... are seeking a Licensed Clinical Behavioral Health Professional or RN to join our team! The ideal candidate will...preferred. Experience working with providers and healthcare teams to review care services related to mental health… more
- CVS Health (Atlanta, GA)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... with behavioral health background. **Preferred Qualifications** + 3 years Managed care /utilization review experience preferred. + Crisis intervention skills and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …complete an ADN-to-BSN program within two years of entering the RN Clinician role. Licensure: + A valid, unencumbered Registered Nursing License approved by ... cancer screening - ( this location sends out the Prep Instructions and review any questions the patients may have). **Key Responsibilities:** Clinical Practice &… more
- CVS Health (Atlanta, GA)
- …residence. + 3+ years clinical experience. **Preferred Qualifications** + Appeals, Managed Care , or Utilization Review experience. + Proficiency with computer ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...**Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant** to join our remote team. In this… more
- Elevance Health (Atlanta, GA)
- …law. * Must have compact license for the state of Georgia The **Medical Management Nurse ** is responsible for review of the most complex or challenging cases ... Director on particularly peculiar or complex cases as the nurse deems appropriate. + May make recommendations on alternate...and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any… more