- 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 ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
- Fresenius Medical Center (Cumming, GA)
- …Case Manager for patients with various shifts and work hours **PURPOSE AND SCOPE:** The registered professional nurse (CAP RN 1) position is an entry level ... designation into the Clinical Advancement Program for Registered Nurses. The CAP RN 1 is...years. + Minimum of 9 months experience as a Registered Nurse (preferred). + Chronic Home dialysis… more
- Fresenius Medical Center (Atlanta, GA)
- …1968 Peachtree Rd NW, Atlanta, GA 30309** **PURPOSE AND SCOPE:** The Inpatient RN provides direct patient care in accordance to company policies and procedures which ... dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to… more
- Fresenius Medical Center (Lithonia, GA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Actalent (Atlanta, GA)
- Utilization Review - Registered Nurse Job...Benefits - Appeals, and Risk Management. Essential Skills + Registered Nurse ( RN ) with a valid ... Description This role involves performing precertification and medical necessity reviews for designated referrals and targeted outpatient procedures, services, and… more
- Cognizant (Atlanta, GA)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...the medical necessity determinations to the Health Plan/ Medical Director based on the review of… more
- Vatica Health (Atlanta, GA)
- …+ Minimum of 3 years of recent adult health clinical experience as a Registered Nurse ( RN )- preferably in critical care (ie, ICU/CCU/MICU) and/or ... Are you an RN looking for a career opportunity in healthcare...and detailed-oriented nurses to join our team. As a Nurse Consultant, you will collect, review and… more
- Elevance Health (Atlanta, GA)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Elevance Health (Atlanta, GA)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...Skills and Experiences:** + ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review… more
- Elevance Health (Atlanta, GA)
- …unless an accommodation is granted as required by law. The ** Medical Management Nurse ** is responsible for review of the most complex or challenging cases ... ** Medical Management Nurse ** **Hours: 8am-6pm flexible...and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of… more
- Molina Healthcare (Atlanta, GA)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- BioLife Plasma Services (Duluth, GA)
- …+ Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or Physician ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… 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 ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Atlanta, GA)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… 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 ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… 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 ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
- Dialysis Clinic, Inc. (Atlanta, GA)
- …experience; experience preferred **Benefits:** + Paid training with preceptor + Charge nurse continuing education classes + Comprehensive medical , dental and ... to physician; implement and document orders + Participate in patient care conferences, medical rounds and chart review ; document progress notes + Contribute to… more
- Molina Healthcare (Atlanta, GA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… 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 ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… 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 ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more