- Kaiser Permanente (Atlanta, GA)
- Kaiser Permanente is seeking a Registered Nurse ( RN ) Case Management for a nursing job in Atlanta, Georgia.Job Description & RequirementsSpecialty: Case ... Associates Degree Nursing. License, Certification, Registration Registered Professional Nurse License (Georgia) Licensed Registered Nurse (Temporary… more
- GHR Healthcare (Atlanta, GA)
- Are you a detail-oriented RN with a knack for navigating complex medical cases? Do you thrive on making critical decisions that impact patient care? Join us as a ... Care Management Coordinator and play a key role in evaluating...a resource for members navigating the healthcare system. Data Management : Maintain accurate records and report trends or issues… more
- Legend Biotech USA, Inc. (Atlanta, GA)
- …to: enhance proper administration, and educate on appropriate adverse identification and management . This is a field-based role that works closely with sales, ... Conducts peer-to-peer in-person and virtual educational programs through 1:1 APP/ Nurse and group presentations; Meet with identified customers in each… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) Compact license… more
- Humana (Atlanta, GA)
- …related to Utilization Management and/or Behavioral Health. + Registered Nurse or Behavioral Health Licensed Professional. + Managed care, Medicaid ... + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time… more
- Highmark Health (Atlanta, GA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Fresenius Medical Center (Lawrenceville, GA)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Veterans Affairs, Veterans Health Administration (Atlanta, GA)
- …or Scope of Assigned Duties: The Nurse Employee Occupational Health (EOH) Registered Nurse ( RN ) is responsible for providing competent, evidence-based ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. The EOH RN contributes to...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Highmark Health (Atlanta, GA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... required depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case … more
- ChenMed (Decatur, GA)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The incumbent in this role ... degree in a healthcare related field preferred + Valid, active licensure as professional nurse ( RN , LPN or other nursing discipline) required + A minimum of… more
- Humana (Atlanta, GA)
- …SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse ( RN ) Credentials + Home Health, Durable Medical Equipment, and/or ... Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The… more
- Evolent Health (Atlanta, GA)
- …or third-party administrator - **Required** + Understanding of appeals process and utilization management - **Required** + Working knowledge of regulatory and ... Initiate, research and refer member appeals to the Appeals RN + Initiate, research and resolve provider appeals or...and resolve provider appeals or refer to the Appeals RN , as necessary + Generate resolution letters, as appropriate… 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 ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… 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 ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- CenterWell (Stockbridge, 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, ... sit on-site at our Stockbridge, GA branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …of an accredited prelicensure nursing program. All candidates must be currently licensed as a Registered Nurse in the state of Georgia and have less than 12 ... awareness of AACN Synergy Model for Patient Care. Begins to develop time management skills. Able to access and locate policies and procedures on line. Able… more
- Fresenius Medical Center (Marietta, GA)
- …to ensure quality service while maintaining a high level of efficiency management . **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Manage the tactical execution of ... contracted facilities. Ensure efficient staff/ patient scheduling and efficient staffing utilization following company policy while maintaining a safe environment. +… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Part Time/ 24 Hours **Emory University Hospita** l is seeking an experienced ICU RUN Nurse . The (RUN) Resource Utilization Nurse is primarily responsible for ... and Healthcare Provider certifications required JOB DESCRIPTION: + The (RUN) Resource Utilization Nurse is primarily responsible for supporting the critical care… more
