• Utilization Management Nurse…

    CVS Health (Atlanta, GA)
    …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
    CVS Health (05/17/25)
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  • Senior Nurse Consultant - Atlanta…

    PruittHealth (Atlanta, GA)
    **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he is ... operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required… more
    PruittHealth (04/18/25)
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  • Consultant , Nurse Disability

    Lincoln Financial (Atlanta, GA)
    …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization....will provide coaching and guidance to claims regarding medical management . **What you'll be doing** * Evaluate medical information… more
    Lincoln Financial (05/22/25)
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  • Appeals Nurse Consultant - Remote…

    CVS Health (Atlanta, GA)
    …in time zone of residence **Monday - Friday.** **Position Summary** The Appeals Nurse Consultant position is responsible for processing the medical necessity of ... in state of residence **Preferred Qualifications** + Managed Care experience + Utilization Management experience + Appeals experience + Pre Certification… more
    CVS Health (05/22/25)
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  • Senior Clinical Strategy Consultant

    Highmark Health (Atlanta, GA)
    …​ **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality, care, utilization , high-cost claim, and population health management . Must be a ... in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
    Highmark Health (05/10/25)
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