- Actalent (Atlanta, GA)
- …(Rotating weekends) About the Role We are seeking a detail-oriented and compassionate Utilization Review Registered Nurse ( RN ) to join our team. In ... Job Title: Utilization Review RN Location: Buckhead, GA (on-site position) Schedule: Monday-Friday, 8:30 AM-5:00 PM… more
- Actalent (Vinings, GA)
- …internal teams (claims, benefits, appeals, risk management). Qualifications: + 1+ years of utilization management / utilization review / case management ... Immediate Hiring for "UM RN " in Atlanta ,GA Must be Located closer...be Located closer to Atlanta, GA Job Description: + Review and approve precertification and medical necessity for designated… more
- Waystar (Atlanta, GA)
- …end user adoption of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer...Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure) + 8+ years of clinical experience in… more
- Fresenius Medical Center (Gainesville, GA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Fresenius Medical Center (Carrollton, GA)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- State of Georgia (GA)
- …and/or audits according to established rules, regulations and other statutes Minimum Qualification: Registered Nurse ( RN ) required + Some positions may ... Complnc Specialist 3 - Registered Nurse Georgia (https://ga.referrals.selectminds.com/jobs/75386/other-jobs-matching/location-only) New Hot Regulatory… more
- 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 ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Humana (Atlanta, GA)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Molina Healthcare (Macon, GA)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 2 years clinical nursing experience, including at least 1 year of utilization review , medical claims review , long-term services and supports (LTSS), claims… more
- Molina Healthcare (GA)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more