- Emory Healthcare/Emory University (Atlanta, GA)
- …And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting thorough medical necessity reviews to ... extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department...+ Licensure - Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
- Centene Corporation (Atlanta, GA)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... to performance, compliance , quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
- Emory Healthcare/Emory University (Decatur, GA)
- …more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor ( Registered Nurse / RN )** . This individual will be responsible ... procedures, clinical criteria guidelines, status designation, notification and authorization, compliance and regulatory standards, and case management systems.… more
- 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 (Griffin, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... sit on-site at our Griffin, GA branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Molina Healthcare (Savannah, GA)
- … compliance . **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Licensed Registered Nurse ( RN ), Licensed Vocational Nurse ... an ongoing member case load for regular outreach and management . + As a Lead RN provide...run every workday and cases found non-compliant or missing compliance elements are remediated promptly + Case Management… 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 ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- Gentiva (Douglasville, GA)
- …Executive Director to join our leadership team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care, ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- Molina Healthcare (Augusta, GA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Atlanta, GA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more