- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Ongoing mentorship and leadership programs + And more! **Description** The **Registry Utilization Review Nurse ** (PRN) is responsible for conducting ... attending physician and/or physician advisor. + The UR RN (PRN) will perform utilization review by completing a timely and comprehensive review of all new… more
- CVS Health (Atlanta, GA)
- …all with heart, each and every day. **Position Summary** This Case Manager - Registered Nurse (RN) position is with Aetna's National Medical Excellence (NME) ... to apply, however, preference is for candidates in compact Registered Nurse (RN) states. This role is...is a blended role doing both Case Management and Utilization Management. The RN Case Manager is responsible for… more
- Sharecare (Atlanta, GA)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Healthfirst (GA)
- …as assigned **Minimum Qualifications:** + Associates degree + New York State Registered Nurse + Work experience demonstrating verbal and written communication ... **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review ,… more
- Fresenius Medical Center (Newnan, 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 (Lithonia, 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
- STG International (Milledgeville, GA)
- …regulations and guidelines that govern the facility. + Coordinate with the scheduler to ensure a Registered Nurse (RN) is on duty at least 8 hours a day/7 day a ... nursing practices. + Must possess a current unencumbered active license to practice as a Registered Nurse (RN) or LPN/LVN in the state of Georgia. + Must be… more
- Veterans Affairs, Veterans Health Administration (Dublin, GA)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge… more
- Molina Healthcare (GA)
- …Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable state ... in good standing. **Preferred Education** Completion of an accredited Registered Nurse (RN) Program or a bachelor's degree in Nursing. **Preferred Experience**… more
- Molina Healthcare (Savannah, GA)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more