- Emory Healthcare/Emory University (Decatur, GA)
- …programs and more! **Description** **8a-5:30p / Full Time / 36 hours** The **(RUN) Resource Utilization Nurse , LTAC** is primarily responsible for supporting ... we fuel your professional journey with better benefits, valuable resources , ongoing mentorship and leadership programs for all types...direct patient care assignment as needed while the primary nurse is off unit with another patient, and assisting… more
- 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 (Atlanta, GA)
- …skills, both verbal and written **Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN ... we do it all with heart, each and every day. Requisition Job Description Utilization Management is a 24/7 operation and work schedule may include weekends and… more
- Emory Healthcare/Emory University (Atlanta, 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 / PRN Emory… more
- Fresenius Medical Center (Woodstock, 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
- 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
- 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 (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
- 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
- Molina Healthcare (Atlanta, 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
- 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
- Humana (Atlanta, GA)
- …and/or Behavioral Health; MED-Deeming accreditation standards knowledge is a plus. + Registered Nurse or Behavioral Health Licensed Professional. + Managed care, ... Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time… more
- CenterWell (Decatur, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... is referred to as our Decatur, GA branch.** The ** RN Clinical Manager** coordinates and oversees all direct care...insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Fresenius Medical Center (Decatur, GA)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... contrast media injections for possible complications or reactions. + Acts as a resource for the patient to address patient concerns and questions. + Identifies and… more
- Select Medical (Atlanta, GA)
- …**Case Manager** _Requires a current licensure in a clinical discipline either as a Nurse ( RN /LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work ... what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning,...**Current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist ( RN preferred)… more
- 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 ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...In this role you will act as a clinical resource for Group Protection benefit specialists and claim professionals.… more
- Elevance Health (Atlanta, GA)
- ** Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... integration, and ensures essential face-to-face onboarding and skill development. The ** Nurse Case Manager II** will be responsible for care management within… more
- Elevance Health (Atlanta, GA)
- ** Nurse Audit Sr.** **Hospital Billing - UB/IB Medical Records** **Program Integrity** **Virtual:** This role enables associates to work virtually full-time, with ... determined to recover, eliminate and prevent unnecessary medical-expense spending._ The ** Nurse Audit Sr.** is responsible for identifying, monitoring, and analyzing… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager Senior** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager Senior** is responsible for care management within the scope of… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager Senior** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager Senior** is responsible for care management within the scope of… more