- Molina Healthcare (Atlanta, GA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... emergency room. Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Atlanta, GA)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… 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
- Centene Corporation (Atlanta, GA)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... process preferred. Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.… more
- CVS Health (Atlanta, GA)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... with behavioral health background. **Preferred Qualifications** + 3 years Managed care /utilization review experience preferred. + Crisis intervention skills and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …complete an ADN-to-BSN program within two years of entering the RN Clinician role. Licensure: + A valid, unencumbered Registered Nursing License approved by ... cancer screening - ( this location sends out the Prep Instructions and review any questions the patients may have). **Key Responsibilities:** Clinical Practice &… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments ... and independent determination of the appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets data obtained from clinical records to… more