• Resource Utilization Nurse

    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
    Emory Healthcare/Emory University (06/27/25)
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  • 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 (07/11/25)
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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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  • Dialysis Clinical Manager Registered

    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 (06/14/25)
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  • Patient Flow Coordinator Registered

    Emory Healthcare/Emory University (Atlanta, GA)
    …Healthcare we fuel your professional journey with better benefits, valuable resources ,ongoingmentorshipand leadership programs for all types of jobs, and asupportive ... with patients/customers/team members according to established behavioral standards. + Resource Management: - Collaborates with bed planners and transfer center… more
    Emory Healthcare/Emory University (07/04/25)
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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 (07/09/25)
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  • Nurse ( RN MGR/Head Nurse )

    Veterans Affairs, Veterans Health Administration (Atlanta, GA)
    …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... quality improvement process and initiatives as well as customer service programs. The Nurse Nurse Manager (NM) is the designated first-line supervisory authority… more
    Veterans Affairs, Veterans Health Administration (07/12/25)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Atlanta, 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 (07/12/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Duluth, 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 Gwinnett, GA branch.** The ** RN Clinical Manager** coordinates and oversees all direct care...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (06/18/25)
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  • Care Manager RN (Delaware)

    Highmark Health (Atlanta, GA)
    …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN ... appropriateness of health care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a… more
    Highmark Health (07/08/25)
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  • Disease Management Nurse - Remote

    Sharecare (Atlanta, GA)
    …techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse ... for their chronic condition. By providing health education and resources , reviewing the provider's plan of care with the...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
    Sharecare (07/12/25)
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  • Acute Dialysis Services Program Manager…

    Fresenius Medical Center (Marietta, GA)
    …position will work at 1963 Peachtree Road NW in Buckhead. Candidate must be a licensed Registered Nurse and possess a min. 6 months of experience working in a ... facilities. Ensures efficient staff/ patient scheduling and efficient staffing utilization following company policy while maintaining a safe environment. +… more
    Fresenius Medical Center (06/14/25)
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  • Nurse

    Veterans Affairs, Veterans Health Administration (Atlanta, GA)
    Summary This Registered Nurse position is available in Community Care. Responsibilities DutiesThe duties for Community Care Nurse Educator includes, but not ... level degree in Nursing may have opportunity to become registered as a nurse with a state...10+ years of managed care experience 10+ years of utilization management experience (utilizing Interqual & Milliman) 3.5 years… more
    Veterans Affairs, Veterans Health Administration (07/13/25)
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  • Med Mgmt Nurse (US)

    Elevance Health (Atlanta, GA)
    **Medical Management Nurse ** **Work schedule: M-F 11am-8pm PST.** **Location** : This role enables associates to work virtually full-time, with the exception of ... is granted as required by law._** The **Medical Management Nurse ** is responsible for review of the most complex...do not satisfy relevant clinical criteria. Acts as a resource for Clinicians. May work on special projects and… more
    Elevance Health (07/12/25)
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  • Med Mgmt Nurse (US)

    Elevance Health (Atlanta, GA)
    **Medical Management Nurse ** **Work schedule: M-F** **8:00am to 5:00pm EST. Will work 2-3 Saturdays per year** **Location:** This is a virtual position This role ... unless an accommodation is granted as required by law._** The **Medical Management Nurse ** is responsible for review of the most complex or challenging cases that… more
    Elevance Health (07/12/25)
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  • Endoscopy Service Coordinator RN

    Emory Healthcare/Emory University (Atlanta, GA)
    …At Emory Healthcare we fuel your professional journey with better benefits, valuable resources , ongoing mentorship and leadership programs for all types of jobs, and ... for fostering relations and building rapport with physicians to ensure continued utilization of the service line specialty. + Functions as the communications link… more
    Emory Healthcare/Emory University (07/08/25)
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  • Nurse Case Mgr II (US)

    Elevance Health (Atlanta, GA)
    **Telephonic Nurse Case Manager II** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while ... in different states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
    Elevance Health (07/12/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Atlanta, GA)
    **Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
    Elevance Health (07/12/25)
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  • Nurse Case Manger II

    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 (07/11/25)
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  • Regional Field Director, RNS Program Management

    United Therapeutics (Atlanta, GA)
    …years of PAH nursing experience, including ICU and critical care of PAH patients + Registered Nurse ( RN ) - State Licensure and/or Compact State Licensure ... and European clinical studies + Serve as an educational resource deployed to help ensure that physicians, nurses and...RN - Registered Nurse - State Licensure and/or Compact… more
    United Therapeutics (06/05/25)
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