• Utilization Review Registered

    Emory Healthcare/Emory University (Atlanta, GA)
    …+ Ongoing mentorship and leadership programs + And more! **Description** The **Registry Utilization Review Nurse ** (PRN) is responsible for conducting ... attending physician and/or physician advisor. + The UR RN (PRN) will perform utilization review by completing a timely and comprehensive review of all new… more
    Emory Healthcare/Emory University (06/21/25)
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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 in a ... hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (06/28/25)
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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 in a ... hospital setting. - A Registered Nurse that holds an active, unrestricted...lower levels of care. - 1+ years' experience in Utilization Review . - CCM and/or other URAC… more
    CVS Health (06/25/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Atlanta, GA)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... 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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  • Utilization Management Clinician Behavioral…

    CVS Health (Atlanta, GA)
    …in the state of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification, or experience in state ... Monday through Friday 8:30-5pm EST. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral… more
    CVS Health (06/25/25)
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  • Clinical Reviewer, Nurse Surgery - Part…

    Evolent (Atlanta, GA)
    …are applied appropriately. **Qualifications:** + Current, unrestricted state licensure as a Registered Nurse + Associate or Bachelors in Nursing (Must be ... , you will be a key member of the utilization management team. We can offer you a meaningful...a Registered Nurse ) + Strong interpersonal and communication… more
    Evolent (06/17/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Atlanta, GA)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be… more
    Molina Healthcare (06/20/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Duluth, GA)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
    CenterWell (06/18/25)
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