- 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 (Duluth, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home...RN ). + Home health experience is required. + Management and people leadership experience is required. + OASIS… more
- Molina Healthcare (GA)
- …services and supports (LTSS), or equivalent combination of relevant education and experience. + Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), ... + Excellent organizational, problem-solving and critical-thinking skills. **Preferred Qualifications** + Registered Nurse ( RN ). The license must be… more
- Molina Healthcare (Columbus, GA)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… 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
- Healthfirst (GA)
- …Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management /case management . ... This position is 100% Remote . We are hiring for the following schedules...process + Additional duties as assigned Minimum Qualifications: + RN , LPN OR Dental Hygienist Preferred Qualifications: + Bachelors… more
- Lincoln Financial (Atlanta, GA)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at home employee residing outside...for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… 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 )...volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's… more
- Highmark Health (Atlanta, GA)
- …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year of ... + In-depth knowledge of the pharmacy industry, including benefit design, formulary management , and pharmacy best practices. + Proven ability to interpret and analyze… more