- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for clinical member services review assessment processes. Responsible ... experience. Candidates with MCO experience are highly preferred. The Care Review Clinician must be...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...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 ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… 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 ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… 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
- Emory Healthcare/Emory University (Decatur, GA)
- …**Unit Charge, Critical Care Stepdown LTAC** responsible for being a capable clinician who has acquired broad experience in caring for patients and has developed ... a sound understanding about the care of a particular patient population and routinely uses...experience to respond to changes in clinical situations. This RN professional is able to apply the Synergy Model… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …_development,_ and leadership programs + And more **Description** We're seeking a ** Registered Nurse , Vascular Access** responsible for being a capable ... RN professional can apply the Synergy Model for Care in practice and use this knowledge to personalize...to colleagues and strong advocate for them. + Capable clinician who has acquired broad experience in caring for… more
- Highmark Health (Atlanta, GA)
- …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
- Datavant (Atlanta, GA)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… 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
- Elevance Health (Atlanta, GA)
- …in different states; therefore, Multi-State Licensure will be required.** The **Medical Management Nurse ** is responsible for review of the most complex or ... **Medical Management Nurse ** **Location Virtual: This role enables associates to...and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any… more
- Elevance Health (Atlanta, GA)
- …law. * Must have compact license for the state of Georgia The **Medical Management Nurse ** is responsible for review of the most complex or challenging cases ... Director on particularly peculiar or complex cases as the nurse deems appropriate. + May make recommendations on alternate...and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any… more