• Utilization Management Nurse

    CVS Health (Atlanta, GA)
    …both verbal and written. **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting. + Must have active ... current and unrestricted RN licensure in state of residence. + ...time off, flexible work schedules, family leave, dependent care resources , colleague assistance programs, tuition assistance, retiree medical access… more
    CVS Health (05/17/25)
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  • Rapid Response Registered Nurse

    Emory Healthcare/Emory University (Lithonia, GA)
    …are ready to join a team that's redefining quality nursing care. The (RUN) Resource Utilization Nurse is primarily responsible for supporting the critical ... incentives + Ongoing mentorship, _development,_ and leadership programs **Description** **Rapid Response Registered Nurse / RN ** 7p-7:30a / Full Time… more
    Emory Healthcare/Emory University (04/25/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Atlanta, GA)
    …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills… more
    Lincoln Financial (05/22/25)
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  • Registered Nurse RN Case…

    HCA Healthcare (Vidalia, GA)
    **Description** **Introduction** Do you have the career opportunities as a ** Registered Nurse ( RN ) Case Manager** you want in your current role? We invest in ... pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k)...! **Job Summary and Qualifications** We are seeking a Registered Nurse ( RN ) Case Manager… more
    HCA Healthcare (05/07/25)
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  • Registered Nurse RN Care…

    AdventHealth (Calhoun, GA)
    …Whitfield, Catoosa, Murray, Floyd and Bartow. **The role you'll contribute:** The Home Health Registered Nurse ( RN ) Care Manager is a professional nurse ... Day One + Career Development + Whole Person Wellbeing Resources **Our promise to you:** Joining AdventHealth is about...care patient's care based on individual patient needs. The RN Care Manager is responsible for independent management of… more
    AdventHealth (04/04/25)
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  • Clinical Manager Registered Nurse

    Fresenius Medical Center (Lithonia, GA)
    …reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters. + Technically proficient in the specific department and ... the form of objectives and determines how to use resources to meet schedules and goals. + An individual...and adherence to treatment regime. + Acts as a resource for the patient to address patient concerns and… more
    Fresenius Medical Center (05/23/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Thomson, GA)
    …background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and ... development plans for all direct reports. + Partners with internal Human Resources , Quality, and Technical Services departments. + Collaborates with or functions as… more
    Fresenius Medical Center (05/08/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Atlanta, GA)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
    Sharecare (05/10/25)
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  • Case Manager, Registered Nurse

    CVS Health (Atlanta, GA)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
    CVS Health (05/16/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Atlanta, GA)
    …care. - Perform medical necessity reviews. **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...in a hospital setting. - A Registered Nurse that holds an active, unrestricted… more
    CVS Health (05/16/25)
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  • Registered Nurse , Telehealth…

    ChenMed (Decatur, GA)
    …rapidly expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic triage directional patient ... related issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in… more
    ChenMed (04/24/25)
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  • Registered Nurse , Telehealth,…

    ChenMed (Riverdale, GA)
    …expanding and we need great people to join our team. The Part Time Registered Nurse , Virtual Care, is responsible for providing telephonic emergency triage and ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call… more
    ChenMed (05/20/25)
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  • RN Assistant Nurse Manager - Med…

    AdventHealth (Rome, GA)
    …AL, and Chattanooga, TN. **The role you'll contribute:** **GENERAL SUMMARY** **:** The Assistant Nurse Manager (ANM) is a registered professional nurse who ... quality of care is delivered to our patients and demonstrates effective stewardship of resources . The Assistant Nurse Manager is the change agent for the… more
    AdventHealth (03/17/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Columbus, GA)
    …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... during Fair Hearings as may be required. + Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and Member/Provider… more
    Molina Healthcare (05/16/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Atlanta, GA)
    …related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or ... to identify opportunities for process and quality improvements within utilization management + Educates and provides resources ...within utilization management + Educates and provides resources for utilization management team on key… more
    Centene Corporation (05/21/25)
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  • RN Case Manager

    HCA Healthcare (Waycross, GA)
    …with purpose and integrity. We care like family! Jump-start your career as a ** Registered Nurse ( RN ) Case Manager** today with **Memorial Satilla Health** ... pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k)...vary by location._** Come join our team as a ** Registered Nurse ( RN ) Case Manager**… more
    HCA Healthcare (04/27/25)
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  • RN Case Manager

    HCA Healthcare (Savannah, GA)
    …**Introduction** Do you want to join an organization that invests in you as a Registered Nurse ( RN ) Case Manager? At Memorial Health University Medical ... pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k)...make a difference. We are looking for a dedicated Registered Nurse ( RN ) Case Manager… more
    HCA Healthcare (04/04/25)
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  • Transplant Care Nurse RN - Stem…

    Highmark Health (Atlanta, GA)
    …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... and addressing barriers, helping members to coordinate care, and identifying various resources to assist members in achieving their personal health goals. Will work… more
    Highmark Health (04/25/25)
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  • RN Medical Claim Review Nurse

    Molina Healthcare (Columbus, GA)
    …denial or modification of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (05/21/25)
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  • RN Case Manager PRN

    HCA Healthcare (Augusta, GA)
    **Description** **Introduction** Do you have the PRN career opportunities as a ** Registered Nurse ( RN ) Case Manager** you want with your current employer? We ... your knowledge and expertise! **Job Summary and Qualifications** We are seeking a ** Registered Nurse Case Manager** for our department who will provide clinical… more
    HCA Healthcare (05/13/25)
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