- Molina Healthcare (Columbus, GA)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
- Fresenius Medical Center (Phenix City, AL)
- **PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff ... Registered Nurse , to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's… more
- Elevance Health (Columbus, GA)
- …have License to practice in the state of Georgia** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging cases that ... whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do...Director on particularly peculiar or complex cases as the nurse deems appropriate. + May make recommendations on alternate… more
- Molina Healthcare (Columbus, GA)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- BioLife Plasma Services (Columbus, GA)
- …requirements Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… more
- Molina Healthcare (Columbus, 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 ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Columbus, 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 ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Molina Healthcare (Columbus, GA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… more
- Molina Healthcare (Columbus, GA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
- Molina Healthcare (Columbus, 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
- Molina Healthcare (Columbus, GA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Columbus, GA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- CenterWell (Columbus, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Background… more
- Fresenius Medical Center (Columbus, GA)
- …effective dialysis therapy for assigned patients under the direct supervision of a registered nurse . Participates in the implementation and evaluation of patient ... as your own._ **Connect with your goals and change lives** **with Fresenius Medical Care North America.** Here, we make connections that empower patients, their… more
- Battelle Memorial Institute (Fort Benning, GA)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support...data relevant to primary health assessments including a detailed medical history to develop time sensitive treatment plans which… more
- Molina Healthcare (Columbus, GA)
- …related field or equivalent experience, OR completion of any of the following programs: + Registered Nurse ( RN ) or State Licensed Vocational Nurse (LVN), ... in support of annual HEDIS project management and ongoing review of medical records submitted by providers....OR completion of any of the following programs: + Registered Nurse ( RN ) or State… more
- Molina Healthcare (Columbus, GA)
- …Microsoft Excel (edit/save spreadsheets, sort/filter) **Required License, Certification, Association** Licensed registered nurse ( RN ), Licensed practical ... CPT guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or for payment… more