- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... nursing experience, including at least 1 year of utilization review , medical claims review , long-term...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… more
- BioLife Plasma Services (Douglasville, GA)
- …requirements Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… more
- Fresenius Medical Center (Marietta, GA)
- …Marietta, GA 30060** **Dialysis Experience Required** **PURPOSE AND SCOPE:** The Inpatient RN provides direct patient care in accordance to company policies and ... dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to… more
- Fresenius Medical Center (Atlanta, GA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Vatica Health (Atlanta, GA)
- …+ Minimum of 3 years of recent adult health clinical experience as a Registered Nurse ( RN )- preferably in critical care (ie, ICU/CCU/MICU) and/or ... Are you an RN looking for a career opportunity in healthcare...and detailed-oriented nurses to join our team. As a Nurse Consultant, you will collect, review and… more
- PruittHealth (Union City, GA)
- …care or LTC experience. **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** Current and unrestricted Registered Nurse ( RN ) licensure in state of practice. ... staff's demonstration of proper procedures and attitudes and reviewing medical records and documentation. **KEY RESPONSIBILITIES:** 1. Coordinates clinical… more
- CVS Health (Atlanta, GA)
- …(https://protect-usb.mimecast.com/s/HChtCEKL7mupo2P4Q84HN2Ovk?domain=jobs.cvshealth.com) **Required Qualifications** - A Registered Nurse that must ... Assessment of Members through the use of clinical tools and information/data review , conducts comprehensive evaluation of member's needs and benefit plan eligibility… more
- Surgery Care Affiliates (Atlanta, GA)
- …If you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) PreOp. + Promote the mission, vision, and values ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …appropriate. In collaboration with clinical leaders, provides weekly and daily clinical review of the surgical schedule to ensure procedures are posted correctly, ... an acute care hospital operating room as a circulating RN is required in order to acquire broad-base knowledge...be able to accurately and professionally communicate with the medical staff, nursing staff, patients and their family members.… more
- Prime Healthcare (Riverdale, GA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237250/case-manager- registered - nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- Elevance Health (Atlanta, GA)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...Skills and Experiences:** + ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review… more
- BioLife Plasma Services (Duluth, GA)
- …+ Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or Physician ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… more
- Dialysis Clinic, Inc. (Fayetteville, GA)
- …experience; experience preferred **Benefits:** + Paid training with preceptor + Charge nurse continuing education classes + Comprehensive medical , dental and ... to physician; implement and document orders + Participate in patient care conferences, medical rounds and chart review ; document progress notes + Contribute to… more
- Molina Healthcare (Atlanta, 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 ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Elevance Health (Atlanta, GA)
- … necessity. + Extrapolates and summarizes medical information for medical director, consultants and other external review . + Prepares recommendations ... ** Nurse Appeals** **Hybrid 1:** This role requires associates... Appeals** is responsible for investigating and processing and medical necessity appeals requests from members and providers. **How… more
- Molina Healthcare (Atlanta, GA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Atlanta, GA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- CenterWell (Decatur, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home… more
- CenterWell (Atlanta, GA)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home… more
- Evolent (Atlanta, GA)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... are performed within the ** RN /LVN/LPN** scope of practice, under the Medical ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate,… more