• Clinical Registered Nurse…

    Cognizant (Atlanta, GA)
    …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (10/07/25)
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  • Utilization Management Nurse…

    Humana (Atlanta, GA)
    …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...PHI / HIPAA information ​Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    Humana (Atlanta, GA)
    …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (10/18/25)
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  • Manager, Healthcare Services; Utilization…

    Molina Healthcare (GA)
    …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... or more of the following activities: care review, care management , utilization management (prior authorizations,...experience. * At least 1 year of health care management /leadership experience. * Registered Nurse (RN), Licensed… more
    Molina Healthcare (09/19/25)
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  • Director, Healthcare Services; Utilization…

    Molina Healthcare (GA)
    …of healthcare services professionals in some or all of the following functions: utilization management , care management , behavioral health and other ... of the following key health care services functions: care management , utilization management , care transitions,...and experience. * At least 3 years health care management /leadership required. * Registered Nurse (RN), Licensed… more
    Molina Healthcare (09/19/25)
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  • SNF Utilization Management RN…

    Humana (Atlanta, GA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...Weekly Hours: 40 + Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    Humana (09/12/25)
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  • Disease Management Nurse…

    Sharecare (Atlanta, GA)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (10/22/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Atlanta, GA)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... each and every day. **Position Summary** **This is a remote work from home role anywhere in the US...Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (10/23/25)
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  • LVN Delegation Oversight Nurse…

    Molina Healthcare (Atlanta, GA)
    …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
    Molina Healthcare (10/23/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (Atlanta, GA)
    …hours.** **The ideal candidate will have experience in behavioral health utilization management .** **Education/Experience:** Requires Graduate of an Accredited ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (10/10/25)
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