• Clinical Documentation Specialist…

    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
    Houston Methodist (10/29/25)
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  • RN UM Clinical Appeals Nurse Remote

    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
    Molina Healthcare (11/14/25)
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  • Denials Prevention Specialist , Clinician…

    Datavant (Atlanta, GA)
    …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +… more
    Datavant (11/12/25)
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  • Intake and Triage Specialist - Atlanta

    State of Georgia (Fulton County, GA)
    …. Knowledge of DATEP, NTP, ARMHP, and/or CLA services . Experience as a Registered Nurse /LPN, or licensed/certified professional in a related field or setting . ... Intake and Triage Specialist - Atlanta Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/74385/other-jobs-matching/location-only)...Experience in utilization review and/or quality assurance in a… more
    State of Georgia (11/22/25)
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  • Licensed Practical Nurse /Licensed…

    STG International (Milledgeville, GA)
    …regulations and guidelines that govern the facility. + Coordinate with the scheduler to ensure a Registered Nurse ( RN ) is on duty at least 8 hours a day/7 ... reports, evaluations, studies, charting, etc., as necessary. + Periodically review the department's policies and procedures manuals, job descriptions,...Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse … more
    STG International (10/25/25)
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