- Elevance Health (Atlanta, GA)
- ** Medical Management Nurse ** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... members in different states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most… more
- Elevance Health (Atlanta, GA)
- ** Medical Management Nurse ** **Location Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... members in different states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Wellness incentives + Ongoing mentorship, _development,_ and leadership programs **Description** ** Medical ICU Unit Charge Nurse / RN** 7p-7:30a / Full ... their area of specialty. + Completes employee conference, risk management and unit management reports within specified...marking and evidence based practice. + Functions as charge nurse . + Role models delegation skills to colleagues and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …7:30a / Full-Time / 36 Hours** We're seeking a **Clinician Charge** **, Medical Surgical Department** responsible for being a capable clinician who has acquired ... their area of specialty. + Completes employee conference, risk management and unit management reports within specified...marking and evidence based practice. + Functions as charge nurse . + Role models delegation skills to colleagues and… more
- Humana (Atlanta, GA)
- …of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require ... community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Atlanta, GA)
- …of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require ... and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the… more
- Emory Healthcare/Emory University (Decatur, GA)
- …and a leader within their area of specialty. Completes employee conference, risk management and unit management reports within specified time frames. Identifies ... within the unit to provide optimal patient outcomes. Role models time management skills through example. Ensures compliance and adherence with stated policies and… more
- Humana (Atlanta, GA)
- …of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require ... community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Cognizant (Atlanta, GA)
- …to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... denial management and managing clinical denials from Providers to the...Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …failure, infections, paralysis, diabetes, heart failure, hypertension, and stroke + Targeted Nurse -to-Patient Ratio: 1:4 On 6G we pride ourselves in fostering a ... a leader within their area of specialty. + Completes employee conference, risk management and unit management reports within specified time frames. + Identifies… more
- Molina Healthcare (Atlanta, GA)
- …set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Provides support for medical claim and internal ... quality and cost-effective member care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical/ medical reviews of retrospective medical claim reviews, medical… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …do just that! On HG you will work with a variety of patients seeking medical and surgical care. You can strengthen your knowledge and competencies by working with ... heparin drips, tracheostomies, blood products, IV antibiotics, intravascular and central line management , and surgical drain devices. + Number of Beds: 8-bed +… more
- Fresenius Medical Center (Decatur, GA)
- …and acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other FVC ... procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in optimum… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …failure, infections, paralysis, diabetes, heart failure, hypertension, and stroke + Targeted Nurse -to-Patient Ratio: 1:4 On 6G we pride ourselves in fostering a ... their area of specialty. 6. Completes employee conference, risk management and unit management reports within specified...Enhancing your Communication HLC#6488. PLAN: 6. Meets all Clinical Nurse I Employee Commitments. 7. Completion of VIP or… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …failure, infections, paralysis, diabetes, heart failure, hypertension, and stroke + Targeted Nurse -to-Patient Ratio: 1:4 On 6G we pride ourselves in fostering a ... their area of specialty. 7. Completes employee conference, risk management and unit management reports within specified...and specialty PL N: 4. Must meet all Clinical Nurse Employee Commitments. 5. Achieves electives/points and contact hours… more
- ChenMed (Decatur, GA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent adheres to strict departmental goals/objectives, standards ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...responsibilities include but are not limited to: geriatric assessment, medical history, physical exam, diagnosis and treatment, development of… more
- Fresenius Medical Center (Atlanta, GA)
- …to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. + Delivers safe, effective care in a ... Recognition preferred, but not required. + Demonstrates organizational and time management skills, and a competency toward completing continuing and ongoing… 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 ... + Document clinical findings accurately and attest F2F encounters in patient medical records. + Utilize Local Coverage Determination (LCD) criteria per hospice… more
- Humana (Atlanta, GA)
- …the medical and behavioral health spectrum. They will also coordinate with other Medical Management programs (DM/PN) as needed, in addition to MTF UM / CM ... Manager will be a member of the In-Home Case Management Team, providing a comprehensive, holistic approach for case...achieve desired clinical outcomes and to enhance quality of medical care. The **Telephonic Nurse Case Manager**… more
- Humana (Atlanta, GA)
- …of the appropriate courses of action. The Utilization Management Behavioral Health Nurse 2 completes medical record reviews from medical records sent ... community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical...determination of the appropriate courses of action. + Complete medical record reviews + Assess discharge plans + Review… more