- Actalent (Atlanta, GA)
- …+ 1+ years of utilization management / utilization review / case management expereince is must + RN License in GA or Compact License is Mandatory + ... Urgent Hiring for "UM RN " in Atlanta ,GA Must be Located closer to Atlanta, GA Job Description: + Review and approve precertification and medical necessity for… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Actalent (Atlanta, GA)
- …weekends) About the Role We are seeking a detail-oriented and compassionate Utilization Review Registered Nurse ( RN ) to join our team. In this role, you ... Job Title: Utilization Review RN Location: Buckhead, GA...providers, members, and internal teams (claims, benefits, appeals, risk management ). Required Qualifications + Active RN license… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …incentives + Ongoing mentorship, _development,_ and leadership programs **Description** **Rapid Response Registered Nurse / RN ** 7a-7:30a/ Full Time / ... a team that's redefining quality nursing care. JOB DESCRIPTION: The (RUN) Resource Utilization Nurse , WEO is primarily responsible for supporting the critical… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and leadership programs + And more **Description** The **Procedural Service Line Coordinator ( Registered Nurse / RN )** for the **Cardiovascular Operating ... This individual: + Coordinates daily operations, staffing, and case flow and management of inventory, instruments, supplies and equipment for selected service line… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …more **Description** We're seeking a **Cardiovascular Operating Room** **Procedural Service Line Coordinator ( Registered Nurse / RN )** who is responsible for ... This individual: + Coordinates daily operations, staffing, and case flow and management of inventory, instruments, supplies and equipment for selected service line… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ And more **Description** **11am-11:30pm** We're seeking an **Transfer Center Registered Nurse is** responsible for accepting incoming referral information ... via multimedia and working directly with bed management and direct care nursing to coordinate inpatient bed assignments (particularly critically ill) for patients at… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …ready to join a team that's redefining quality nursing care. The (RUN) Resource Utilization Nurse is primarily responsible for supporting the critical care units ... _development,_ and leadership programs **Description** **Rapid Response Unit Charge Nurse / RN ** 7p-7:30a / Full Time...Code Blue. + Assist the emergency department in the management of critical care patients awaiting inpatient bed admission… more
- Fresenius Medical Center (Atlanta, GA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- CVS Health (Atlanta, GA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- Molina Healthcare (Atlanta, GA)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS)… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical ... best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CenterWell (Decatur, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home… more
- CenterWell (Atlanta, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home...RN ). + Home health experience is required. + Management and people leadership experience is preferred. + OASIS… more
- Molina Healthcare (Atlanta, 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 ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Atlanta, GA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Fresenius Medical Center (Marietta, GA)
- Position requires Registered Nurse with experience working in hemodialysis and a passion for building and leading great teams. Will have 25+ direct reports, all ... to ensure quality service while maintaining a high level of efficiency management . **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Manages the tactical execution of… more
- PruittHealth (Atlanta, GA)
- …with long-term care population **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** * Licensed Registered Nurse with current, unrestricted license in state of ... care and regulatory compliance within the company's standards and RN scope of practice. * Comply with PruittHealth Premier's...in a managed care setting focused on experience in utilization review/case management and at least two… more
- Evolent (Atlanta, GA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more
- Highmark Health (Atlanta, GA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... **LICENSES or CERTIFICATIONS** **Required** + Current State of PA RN licensure OR Current multi-state licensure through the enhanced...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more