- 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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Atlanta, GA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Actalent (Atlanta, GA)
- …(RN) with a valid license in GA or Compact. + 1+ years of experience in Utilization Management (UM). + 1+ years of experience in managed care. Additional Skills ... Job Title: Utilization Review - FULLY REMOTE Job Description This...performing eligibility and benefit reviews, identifying patients for case management , conducting quality improvement reviews, and maintaining communication with… more
- AdventHealth (Calhoun, GA)
- …Whitfield, Catoosa and Murray or Floyd and Bartow. **The role you'll contribute:** The Home Health Registered Nurse (RN) Care Manager is a professional nurse ... needs. The RN Care Manager is responsible for independent management of the Home Health patient population...implementation and evaluation for that caseload as the primary nurse . Sets priorities of home care caseload… more
- Sharecare (Atlanta, GA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- STG International (Milledgeville, GA)
- STGi is seeking a LPN/LVN to provide services at our Georgia War Veterans Home . If you have compassion and a passion to care for Veterans, this could be the job for ... facility meets the minimum staffing levels for nurses and nurse aides; complete required posting of nursing staff data...and education for self-help as appropriate. + Provide pain management for residents in accordance with established pain … more
- CVS Health (Atlanta, GA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- ChenMed (Decatur, GA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent adheres to strict departmental goals/objectives, standards ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...care in nursing homes, skilled nursing facilities (SNF) and home settings, or supporting a Cardiologist practice. The responsibilities… more