- Actalent (Atlanta, GA)
- 100% Remote Utilization Management Nurse Description * Reviewing authorization requests * Utilizing evidence-based criteria and making a medically ... utilization review nurse , or prior authorization nurse . Skills clinical review, case management , rn license, medical, claim Top Skills Details… more
- ChenMed (Decatur, GA)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse 1, Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- ChenMed (Decatur, GA)
- …rapidly expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic emergency triage ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
- CVS Health (Atlanta, GA)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... determination of the appropriate courses of action. The SNF Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting thorough medical necessity reviews to ... extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department...+ Licensure - Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
- CVS Health (Atlanta, GA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… 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 ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… 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 ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- CenterWell (Atlanta, GA)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more