- Fresenius Medical Center (Marietta, GA)
- …GA 30143** **MUST HAVE DIALYSIS EXPERIENCE!** **PURPOSE AND SCOPE:** The Inpatient RN provides direct patient care in accordance to company policies and procedures ... dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to… 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
- PruittHealth (Union City, GA)
- …care or LTC experience. **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** Current and unrestricted Registered Nurse ( RN ) licensure in state of practice. ... staff's demonstration of proper procedures and attitudes and reviewing medical records and documentation. **KEY RESPONSIBILITIES:** 1. Coordinates clinical… 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
- Emory Healthcare/Emory University (Atlanta, GA)
- …appropriate. In collaboration with clinical leaders, provides weekly and daily clinical review of the surgical schedule to ensure procedures are posted correctly, ... an acute care hospital operating room as a circulating RN is required in order to acquire broad-base knowledge...be able to accurately and professionally communicate with the medical staff, nursing staff, patients and their family members.… 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...in multiple states. **Preferred Capabilities, Skills and Experiences:** + Medical Management experience is preferred, + Utilization Review… more
- Elevance Health (Atlanta, GA)
- …* Must have compact license for the state of Georgia The ** Medical Management Nurse ** is responsible for review of the most complex or challenging cases that ... whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do...Director on particularly peculiar or complex cases as the nurse deems appropriate. + May make recommendations on alternate… 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
- 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
- Actalent (Atlanta, GA)
- …Customer Service, Claims, Contracts and Benefits - Appeals, and Risk Management. Essential Skills + Registered Nurse ( RN ) with a valid license in GA or ... Job Title: Utilization Review - FULLY REMOTE Job Description This role...REMOTE Job Description This role involves performing precertification and medical necessity reviews for designated referrals and targeted outpatient… 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
- BioLife Plasma Services (Douglasville, GA)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- BioLife Plasma Services (Douglasville, GA)
- …requirements Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or ... 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