- CenterWell (Atlanta, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case ...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home… more
- Houston Methodist (GA)
- …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- AdventHealth (Rome, GA)
- …need to succeed:** + Associate's of Nursing Required + 2 Work Experience Required + Registered Nurse ( RN ) Required This facility is an equal opportunity ... GA, Birmingham, AL, and Chattanooga, TN. **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- Molina Healthcare (Savannah, GA)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
- Battelle Memorial Institute (Fort Benning, GA)
- …Health Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government ... ensuring comprehensive support for those who serve. As a Nurse Case Manager, you will contribute to...professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Elevance Health (GA)
- **Telephonic Nurse Case Manager I** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager I** is responsible for telephonic care management within… more
- Datavant (Atlanta, GA)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Sharecare (Atlanta, GA)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more