• 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 (10/07/25)
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  • Inpatient Utilization Review…

    Emory Healthcare/Emory University (Atlanta, GA)
    …leadership programs + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible for conducting medical ... Interqual Guidelines in conjunction with a review of the patient chart, clinical nursing judgement, and discussions with the attending physician and/or physician… more
    Emory Healthcare/Emory University (10/20/25)
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  • Utilization Management Nurse - Home…

    Humana (Atlanta, GA)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… 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 ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
    Humana (10/18/25)
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  • Registered Nurse ER Clinical

    Community Health Systems (Statesboro, GA)
    …for addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required ... huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate… more
    Community Health Systems (09/25/25)
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  • Associate Manager, Clinical Health Services…

    CVS Health (Atlanta, GA)
    …non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory and accreditation… more
    CVS Health (10/15/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Albany, GA)
    …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
    Fresenius Medical Center (10/17/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Vidalia, 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 (09/26/25)
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  • Clinical Coordinator - Charge…

    Fresenius Medical Center (Bremen, GA)
    …+ Participates in cost control initiatives. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... supply cost goals following all guidelines established in the formularies. + Assists in the development and revision of any applicable policies and procedures for the facility as directed to ensure continuous process improvement. + Initiates, documents and… more
    Fresenius Medical Center (09/13/25)
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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 (10/15/25)
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