- PruittHealth (Atlanta, GA)
- …Minimum three years industry experience in a managed care setting focused on experience in utilization review / case management and at least two years case ... with long-term care population **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** * Licensed Registered Nurse with current, unrestricted license in state of… more
- HCA Healthcare (Savannah, GA)
- …qualifying candidates! Do you want to join an organization that invests in you as a Registered Nurse ( RN ) Case Manager? At Memorial Health University ... make a difference. We are looking for a dedicated Registered Nurse ( RN ) Case... case management is required. + Certification in case management or utilization review … more
- HCA Healthcare (Augusta, GA)
- **Description** **Introduction** Do you have the PRN career opportunities as a ** Registered Nurse ( RN ) Case Manager** you want with your current ... expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse ( RN ) Case...is required for this PRN role. + Certification in Case Management or Utilization Review … more
- Humana (Atlanta, GA)
- …of employment + 3 years clinical RN experience + 2 years of Utilization Review , Case Management, or Quality Management experience + Strong analytical ... case presentations and presents to Patient Safety Peer Review Committee. Audits quality cases for compliance and participates...+ Active licensed RN in state… more
- CVS Health (Atlanta, GA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Elevance Health (Atlanta, GA)
- …of 4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of ... is granted as required by law. The **Medical Management Nurse ** is responsible for review of the...skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has… more
- Actalent (Atlanta, GA)
- Job Title: Utilization Review - FULLY REMOTE Job...Benefits - Appeals, and Risk Management. Essential Skills + Registered Nurse ( RN ) with a ... Skills & Qualifications + Experience with MCG or Interqual is preferred. + Utilization review experience is a plus. Work Environment The position requires… more
- Emory Healthcare/Emory University (Decatur, GA)
- …**Description** We're seeking a **Clinical Utilization Review Nurse Preceptor ( Registered Nurse / RN )** . This individual will be responsible for ... training, mentoring, and coaching for the Utilization Review Department and must be an...experience in UR. + Minimum 1 year as UR RN II or equivalent experience. + Case … more
- State of Georgia (Fulton County, GA)
- …additional experience in the analysis of medical services documentation and related claims 2) Utilization Review 3) Case Management 4) Analysis of CPT codes ... Nurse Investigator Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64040/other-jobs-matching/location-only) Hot… more
- HCA Healthcare (Savannah, GA)
- …experience preferred + InterQual experience preferred + Currently licensed as a Registered Nurse in the state(s) of practice according to law ... supporting a balance of optimal care and appropriate resource utilization . **What qualifications you will need:** + Bachelor's Degree...growth, we encourage you to apply for our Manager Case Management opening. We promptly review all… more