- 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
- Sharecare (Atlanta, GA)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
- Highmark Health (Atlanta, GA)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- CenterWell (Sandy Springs, GA)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... Location** : Sandy Springs, GA **This is not a remote or work-from-home position. This position requires you to...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- CVS Health (Atlanta, GA)
- … states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for telephonically and/or ... personal, convenient and affordable. **Position Summary** This Case Manager RN position is with Aetna's National Medical Excellence (NME)...years' experience in critical care - 6+ months Case Management or Utilization Management experience… more
- Guardian Life (Atlanta, GA)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Highmark Health (Atlanta, GA)
- … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
- Elevance Health (Atlanta, GA)
- …Health location. The ** Nurse Case Manager ll** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** Requires BA/BS… more