- Elevance Health (Atlanta, GA)
- ** Nurse Reviewer I** A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a ... Hours:** **Monday through Friday, 9:30AM - 6PM (CST).** The ** Nurse Reviewer I** is responsible for conducting...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… more
- Evolent (Atlanta, GA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks ... cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims ... coding experience including diagnosis. Candidates with knowledge of CPT/HCPCS codes, record review , chart audit, provider disputes, appeals, and 1500 & UB04 claim… more
- Molina Healthcare (Atlanta, GA)
- …set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, ... responsible for review of documentation to ensure medical necessity and appropriate...quality of care issues. + Assists with Complex Claim review including DRG Validation, Itemized Bill Review ,… more
- State of Georgia (Fulton County, GA)
- Compliance Nurse 2 Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64225/other-jobs-matching/location-only) Hot ... Up for Job Alerts Please visit the DCH jobsite link to review the job posting and apply: If interested, please apply to:… more
- Veterans Affairs, Veterans Health Administration (Atlanta, GA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... the professional development of health care professionals. Evaluates Functional Statement: Nurse III Last Updated: January 29,2024 Page 2 outcomes of evidence-based… more
- Ageless Mens Health (Marietta, GA)
- …through proactive, personalized care. This is a unique opportunity for a Registered Nurse who thrives on both clinical excellence and team leadership, driving growth ... compliance, and financial performance. + Conduct new patient consultations, review medical histories, and perform assessments under established protocols. +… more
- Gentiva (Alpharetta, GA)
- …Partnerships. Transform Hospice Care.** We are seeking a dedicated Hospice Nurse Practitioner to perform Face-to-Face (F2F) encounters essential for hospice ... per hospice policy and regulatory requirements. + Communicate clinical findings, review treatment plans, lab results, diagnostics, and medications with certifying… more
- Dialysis Clinic, Inc. (Atlanta, GA)
- …with a lower caregiver-to-patient ratio than other providers. The **Dialysis Charge Nurse ** supervises nursing personnel to ensure every patient receives the safest ... experience preferred **Benefits:** + Paid training with preceptor + Charge nurse continuing education classes + Comprehensive medical, dental and vision benefits… more
- ChenMed (Decatur, GA)
- … nurse practitioner role. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization, provide family education and identify ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...in-depth documentation through written progress notes and summaries. The Nurse Practitioner, Specialty incumbent must demonstrate the ability to… more
- Sharecare (Atlanta, GA)
- …To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and objectives of the ... manner while ensuring high quality care. The Disease Management Nurse works with participating members to become empowered and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- State of Georgia (Fulton County, GA)
- Full-Time Instructor - Nurse Aide Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/66235/other-jobs-matching/location-only) Hot ... College (ATC) is seeking highly qualified applicants for its Full-Time Instructor ( Nurse Aide) position in the Health & Public Safety Technology department of… more
- CenterWell (Decatur, GA)
- …of our caring community and help us put health first** The Nurse Practitioner, Cardiology applies advanced education and clinical competencies within the cardiology ... specialty to achieve optimal patient outcomes. The Nurse , Cardiology Practitioner works on problems of diverse scope...Medical Director and Lead Cardiologist about quality of care, review of outcome data, policy, procedure and records issues.… more
- CenterWell (Atlanta, GA)
- …on teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (NP) or Physician Assistant (PA) works in our team-based care ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- Elevance Health (Atlanta, GA)
- ** Nurse Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... shift between those hours, including holidays on a rotational basis. The ** Nurse Appeals** is responsible for investigating and processing and medical necessity… more
- Elevance Health (Atlanta, GA)
- ** Nurse Audit Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the exception of ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Senior** will be responsible for identifying, monitoring, and… more
- BioLife Plasma Services (Duluth, GA)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife Plasma Services is a subsidiary ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** Senior Nurse Consultant assumes responsibility for conducting quality assurance reviews in the assigned facilities. Senior Nurse Consultant ... maintain the highest practicable physical, mental or psychosocial well-being. The Nurse Consultant documents findings and composes accurate, detailed reports of each… more
- State of Georgia (Dekalb County, GA)
- Registered Nurse - Admissions Georgia - Dekalb - Decatur (https://ga.referrals.selectminds.com/jobs/73615/other-jobs-matching/location-only) New ... (DBHDD) is currently seeking qualified candidates for the position of Registered Nurse in the Admissions Unit, at Georgia Regional Hospital - Atlanta, located… more
- CVS Health (Atlanta, GA)
- …medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital setting. + ... A Registered Nurse that holds an active, unrestricted license in their...levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred.… more