- Pacer Staffing (Atlanta, GA)
- …regulatory requirements, and HIPAA privacy regulations. . Thorough knowledge of Case Management , Utilization Management , HIPAA Privacy and Security ... Job Summary . Provides Disease Management (DM) services to TRICARE beneficiaries. . The... (DM) services to TRICARE beneficiaries. . The DM nurse will collaboratively assess, plan, implement, coordinate, monitor and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and leadership programs + And more **Description** We're seeking an **Assistant Manager , Utilization Review** , responsible for supervising and coordinating ... activities of personnel in the Utilization Review Department, including: + Staff schedules to ensure...Qualifications: + Must have a valid, active unencumbered Registered Nurse license or temporary permit approved by the Georgia… more
- Select Medical (Atlanta, GA)
- …**Critical Illness Recovery Hospital : Select Specialty Hospital Midtown Atlanta** **RN Nurse Manager ** **$18,000 Sign-on Bonus** **We are having an Open ... characteristic protected under applicable law. Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/300842/rn- nurse - manager /job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share this job **Job ID** _300842_… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …in the hiring process and is responsible for development, evaluation and ongoing management of assigned direct reports. Provides professional nursing care in ... **Description** JOB DESCRIPTION: Supervises and coordinates activities of nursing personnel in one or more patient care units. Verifies that patients' needs are met… more
- Elevance Health (Atlanta, GA)
- …management plan and modifies as necessary. + Assists with development of utilization /care management policies and procedures. + Participates in or leads ... with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs...services in multiple states. + AS or BS in nursing preferred. + Certification as a Case Manager… more
- Elevance Health (Atlanta, GA)
- …**Monday - Friday 10 am - 7 pm EST.** The **Telephonic** ** Nurse Case Manager II** is responsible for care management within the scope of licensure for ... **Telephonic Nurse Case Manager II** At **Federal...or service issues. + Assists with the development of utilization /care management policies and procedures. **Minimum** **Requirements:**… more
- Elevance Health (Atlanta, GA)
- …48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager I** is responsible for telephonic care management within the scope of ... **Telephonic Nurse Case Manager I - $3000...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Atlanta, GA)
- …states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of ... **Telephonic Nurse Case Manager II** **Location: This...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Atlanta, GA)
- …1-2 late nights per month required 11:30am - 8:00pm ET The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Time Time/ 24 Hours **Emory University Hospita** l is seeking an experienced ICU RUN Nurse . The (RUN) Resource Utilization Nurse is primarily responsible for ... and Healthcare Provider certifications required JOB DESCRIPTION: + The (RUN) Resource Utilization Nurse is primarily responsible for supporting the critical care… more
- Peachtree Orthopedics (Sandy Springs, GA)
- …among team members. + Operational Oversight: Step into the shoes of the Nurse Manager in their absence, overseeing day-to-day operations. + Safety First: ... potential harm to personnel and patients. + Communication Hub: Keep the Nurse Manager informed, providing guidance and assistance to staff, anesthesiology,… more
- Prime Therapeutics (Atlanta, GA)
- …+ Clinical and Quality oversight for this program is provided by the Manager , Patient Programs. **Responsibilities** + Registered Nurse (RN). + 5 years ... post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Magellan Credentialing criteria.… more
- Fresenius Medical Center (Decatur, GA)
- …post procedure, under the direction of the Facility Manager , Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- Elevance Health (Atlanta, GA)
- Nurse Audit Lead - Carelon Payment Integrity **Location:** The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a ... is determined to recover, eliminate, and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Disease Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, ... and Experiences:** + Must be eligible for a multi-state license. + BS in nursing preferred. + Prior case management experience is preferred. + Prior disease… more
- Elevance Health (Atlanta, GA)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Requirements:** + BA/BS in a ... is a virtual position. **Schedule:** Monday-Friday 9:00am-5:30pm EST **Responsible for care management within the scope of licensure for members with complex and… more
- ChenMed (Atlanta, GA)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The incumbent in this role ... related field preferred + Valid, active licensure as professional nurse (RN, LPN or other nursing discipline)... discipline) required + A minimum of 7 years' utilization review/case management experience, including psychological aspects… more
- CenterWell (Stockbridge, GA)
- …an accredited School of Nursing . + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance and reliable ... at our Stockbridge, GA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services...transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Highmark Health (Atlanta, GA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of health ... Management + Experience in a clinical setting **Preferred** + Certification in utilization management or a related field + Experience in UM/CM/QA/Managed Care… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …safety for all patients. This individual will: + Provides support to the SPD manager and OR director and direction to the staff, and facilitates the workflow through ... (AAMI), and the International Association of Healthcare Central Service Material Management (IAHCSMM) current standards. + Incumbents are also accountable for… more
