- Fresenius Medical Center (Marietta, GA)
- …position will work at 1963 Peachtree Road NW in Buckhead. Candidate must be a licensed Registered Nurse and possess a min. 6 months of experience working in a ... to ensure quality service while maintaining a high level of efficiency management . **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Manages the tactical execution of… more
- PruittHealth (Atlanta, GA)
- …with long-term care population **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** * Licensed Registered Nurse with current, unrestricted license in state of ... Working with pharmacist and patient/caregiver to ensure medication therapy management and compliance * Implementation of case... compliance with quality patient care and regulatory compliance within the company's standards and RN … more
- Molina Healthcare (Augusta, GA)
- …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...years in one or more of the following areas: utilization management , case management , care… more
- CVS Health (Atlanta, GA)
- … states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for telephonically and/or ... benefit overall claim management . - Utilizes case management processes in compliance with regulatory and...years' experience in critical care - 6+ months Case Management or Utilization Management experience… more
- AdventHealth (Calhoun, GA)
- …transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the ... and understanding of medical necessity are core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across… more
- Pilgrim's (Gainesville, GA)
- …non-occupational health concerns of employees. + Coordinates all worker's compensation management including compliance with requirements of state worker's ... **Description** Occupational Health Manager - RN As an RN currently licensed...the scope of practice and regulation of the State Nurse Practice Act. + Develops and maintains an efficient… more
- Molina Healthcare (Savannah, GA)
- …within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied cases ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- Molina Healthcare (Atlanta, GA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
- Fresenius Medical Center (Hiram, GA)
- …to ensure quality service while maintaining a high level of efficiency management . **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Manage the tactical execution of ... contracted facilities. Ensure efficient staff/ patient scheduling and efficient staffing utilization following company policy while maintaining a safe environment. +… more
- Molina Healthcare (GA)
- …Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more