- Molina Healthcare (Savannah, GA)
- …managed care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are… more
- ChenMed (Decatur, GA)
- …explain nurse practitioner role. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...in-depth documentation through written progress notes and summaries. The Nurse Practitioner, Specialty incumbent must demonstrate the ability to… more
- Sharecare (Atlanta, GA)
- … utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- HCA Healthcare (Savannah, GA)
- …and personal growth, we encourage you to apply for our Clinical Research Nurse opening. We promptly review all applications. Highly qualified candidates will ... We care like family! Jump-start your career as a Clinical Research Nurse today with Memorial Health University Medical Center. **Benefits** Memorial Health… more
- ChenMed (Riverdale, GA)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... expanding and we need great people to join our team. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, regulatory… 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 sessions, ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager I** is responsible for telephonic care management within the… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager Senior** is responsible for care management within the scope of… 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 of… more
- US Tech Solutions (GA)
- …involve computer system data entry, data management, and reporting. + Review criteria-based prior authorizations following policy and procedure. + Provide on-call ... after hours nurse availability for...of related work experience. **Skills:** + Prior Authorization + Utilization Reeview **Education:** + High School Diploma or equivalent… more
- Highmark Health (Atlanta, GA)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more