- CenterWell (Atlanta, GA)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Duluth, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... **Branch Location** : Duluth, GA **This is not a remote or work-from-home position. This position requires you to...transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Molina Healthcare (GA)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- Sharecare (Atlanta, GA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Prime Therapeutics (Atlanta, GA)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
- CVS Health (Atlanta, GA)
- …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + Must have experience using MS Office + Must be willing ... with heart, each and every day. **Position Summary** Fully remote , Monday-Friday 8am - 5pm EST position (shifts may...The Associate Manager is also responsible for oversight of utilization management nurses including the organization and… more
- Humana (Atlanta, GA)
- …for either shift._ **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in either Florida or a compact state ... working with CMS Guidelines, MCG and/or InterQual guidelines. + 2+ years of Utilization Management (UM), Pre-Auth, and/or other managed care review experience. +… more
- Actalent (Atlanta, GA)
- …Active Compact RN License, Compact LPN is okay too + Utilization Management /Concurrent Review experience. + ICU/ER experience. + Strong communication skills. ... ensure the successful completion of cases. Essential Skills + Experience in utilization management , concurrent review, prior authorization, utilization … more
- CenterWell (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license ( RN )...mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's… more