- CVS Health (Atlanta, GA)
- …all with heart, each and every day. **Position Summary** Medicare Predetermination Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
- CVS Health (Atlanta, GA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Atlanta, GA)
- …of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare ... knowledge and expertise to enhance their understanding of utilization management principles and improve their clinical decision-making. Contributes to the… more
- ChenMed (Decatur, GA)
- …position may require participation in risk and quality management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent ... of practice + A minimum of 3 years experience working in Cardiology as a Nurse Practitioner in an out-patient clinical setting + Basic Life Support (BLS)… more
- ChenMed (Morrow, GA)
- …This position may require participation in risk and quality management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to ... our team. The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct patient care in ChenMed/Jencare… more
- State of Georgia (Fulton County, GA)
- …experience in the analysis of medical services documentation and related claims 2) Utilization Review 3) Case Management 4) Analysis of CPT codes and/or ... Nurse Investigator Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64040/other-jobs-matching/location-only) Hot… more
- CenterWell (Griffin, GA)
- …requires you to sit on-site at our Griffin, GA branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient services provided by ... clinical personnel. This role is a focused on both... documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates… more
- ChenMed (Decatur, GA)
- …to ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other programs that maximize and ... ( _with the support of the Care Team and Nurse Practitioner/Physician Assistant depending on ratio_ ). + Assesses...practices and procedures within the Cardiology field + Superior clinical skills in the management of seniors… more