- Northeast Georgia Health System, Inc (Braselton, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health ... Center of Excellence in Minimally Invasive Surgery and Robotic Job SummaryThe Nurse Manager (NM) functions as the first-line administrative nursing leader, with… more
- Pacer Staffing (Atlanta, GA)
- …direction and build group engagement. Technical Skills: Thorough knowledge of Case Management , Utilization Management , TRICARE policies and procedures, HIPAA ... States, as a Licensed Clinical Social Worker or Registered Nurse US Citizenship Must be able to receive a...management within four (4) years of hire. Preferred: 2 years' experience working with populations with serious intellectual… more
- Humana (Atlanta, GA)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- Humana (Atlanta, GA)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
- Veterans Affairs, Veterans Health Administration (Atlanta, GA)
- …AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and 1 year of professional nursing experience ... responsibility for the coordination of care focused on education, self- management , and customer satisfaction throughout the continuum of care....equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Elevance Health (Atlanta, GA)
- …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- Elevance Health (Atlanta, GA)
- …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- State of Georgia (Fulton County, GA)
- …Specific, additional experience in the analysis of medical services documentation and related claims 2 ) Utilization Review 3) Case Management 4) Analysis of ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only)...services. Position requires an active RN License AND two ( 2 ) years of clinical experience AND one (1) year… more
- Humana (Atlanta, GA)
- …ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, Durable ... caring community and help us put health first** The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance Professional 2 … more
- Elevance Health (Atlanta, GA)
- …Level:** Non- Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation ... responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment… more
