• Clinical Registered Nurse…

    Cognizant (Atlanta, GA)
    …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
    Cognizant (12/23/25)
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  • Dialysis Clinical Manager Registered…

    Fresenius Medical Center (Atlanta, GA)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
    Fresenius Medical Center (12/12/25)
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  • Case Manager, Registered Nurse…

    CVS Health (Atlanta, GA)
    …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
    CVS Health (12/25/25)
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  • SNF Utilization Management RN - Compact Rqd

    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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse (RN)** in the (appropriate state)… more
    Humana (12/12/25)
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  • Clinical Reviewer, Nurse (Medical…

    Evolent (Atlanta, GA)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
    Evolent (12/10/25)
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  • A1A UM Nurse Consultant

    CVS Health (Atlanta, GA)
    …performance. **Education** Bachelor's degree preferred/specialized training/relevant professional qualification. Registered Nurse (RN) required. **Prior Relevant ... utilization reviews and assessments, applying evidence-based criteria and clinical knowledge to evaluate the medical necessity and appropriateness of requested… more
    CVS Health (12/26/25)
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  • Medical Review Nurse (RN)

    Molina Healthcare (Atlanta, GA)
    …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in ... for denial or modification of payment decisions. + Serves as a clinical resource for utilization management, CMOs, physicians and member/provider… more
    Molina Healthcare (12/26/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Decatur, GA)
    …Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse (RN) license or Compact State RN license with ... to as our CWHH Decatur, GA branch.** The **RN Clinical Manager** coordinates and oversees all direct care patient...A minimum of 2 years of experience as a Registered Nurse (RN). + Home health experience… more
    CenterWell (11/01/25)
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  • RN Weekend Clinical Manager, Home Health

    CenterWell (Atlanta, GA)
    …Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse (RN) license or Compact State RN license with ... hours starting Friday evening through Monday morning to support clinical operations across multiple home health branch locations.** The...A minimum of 2 years of experience as a Registered Nurse (RN). + Home health experience… more
    CenterWell (11/21/25)
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  • Aetna Commercial Clinical Program…

    CVS Health (Atlanta, GA)
    …empowered to: + Deliver forward-thinking clinical insights derived from analyzing clinical utilization patterns and member behavior impact on medical costs. ... internal partners and customers. **Required Qualifications** + Active, unrestricted registered nurse (RN) license + Minimum 5...nurse (RN) license + Minimum 5 years of clinical experience + At least 3 years in acute… more
    CVS Health (12/26/25)
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