- Molina Healthcare (Savannah, GA)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- STG International (Milledgeville, GA)
- …+ Assist the Director of Nursing in planning clinical supervision for nurse aide trainees, nursing students and newly hired nurses. + Assist in training ... STGi is seeking a Licensed Practical Nurse /Licensed Vocational Nurse to provide services...reports, evaluations, studies, charting, etc., as necessary. + Periodically review the department's policies and procedures manuals, job descriptions,… more
- Sedgwick (Atlanta, GA)
- …(10) of related experience required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & ... Workplaces in Financial Services & Insurance Sr VP Medical Director (Hourly) The ideal candidate would work 8-20 hours...+ Knowledge of ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical… more
- Elevance Health (Atlanta, GA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... **Medical Management Nurse ** **Location:** This role enables associates to work...is medically necessary and provides consultation to the Medical Director on cases that are unclear or do not… 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
- Fresenius Medical Center (Loganville, GA)
- …Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our employees are our most important ... auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic… more
- CenterWell (Savannah, GA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Fresenius Medical Center (Newnan, GA)
- …the daily operations of the dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care ... leadership. As a Facility Administrator, you may advance your career into a Director of Operations then senior leadership role. **Our culture:** We believe our… more
- AdventHealth (Rome, GA)
- …under the general supervision of the Care Management Supervisor or Manager or Director of Nursing and is responsible for patient evaluations of post-hospital needs; ... physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
- HCA Healthcare (Savannah, GA)
- …and Qualifications** The Manager Case Management reports to the Case Management Director and is responsible for promoting patient-centered care by coordinating all ... throughput while supporting a balance of optimal care and appropriate resource utilization . **What qualifications you will need:** + Bachelor's Degree in Nursing OR… more