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RN, Clinical Documentation Improvement, Atlanta
Minimum 5 years’ experience in nursing in an acute care setting through direct patient care, utilization review, case management or quality review....
Quality Assurance/Education Nurse
Syl-View Rehabilitation & Memory Care Center - Sylvania, GA 30467
Coordinates the facility quality assessment and assurance committee, including the areas of infection control, pharmacy, and utilization review....
Easily apply
Endoscopy (RN) Manager/ASC Manager
Confidential Healthcare Company - Atlanta, GA
Current unencumbered Georgia Registered Nurse license. Monitors FTE utilization and makes recommendations to promote cost effective man-hour practices....
Easily apply

Medical Review Nurse (ATL) - Home-based - Nationwide Opening...

Quality Health Strategies - 9 reviews - Atlanta, GA 30303 (Five Points area)
The Medical Review Nurse - Claims Analyst is a mid-level professional performing medical record and claims review for Medicare, Medicaid, and/or other claims...
Easily apply

RN- Appeals Nurse Consultant- Registered Nurse

Aetna - 2,343 reviews - Atlanta, GA
Concurrent review, appeals, pre-cert or utilization management experience preferred. The Appeals Nurse Consultant is responsible for the review and resolution...

Clinical Quality Specialist

CareSource - 104 reviews - Atlanta, GA
Experience in case management, managed care terms, and practices or utilization review is preferred. Completion of an accredited Registered Nurse (RN) degree...

UM Nurse Associate

Aetna - 2,343 reviews - Atlanta, GA
The UM Nurse Associate applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for...

Prior Authorization Nurse I

Peach State Health Plan - 470 reviews - Smyrna, GA
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...

Registered Nurse-Clinical Nurse Leader

Veterans Affairs, Veterans Health Administration - 2,891 reviews - Decatur, GA
$54,104 - $106,296 a year
Previous Clinical Nurse Leader. Practice, ethics and resource utilization; VA Handbook 5005, Part II, Appendix G6 Nurse Qualification Standard....

Clinical Documentation Specialist

Wellstar Health System - 350 reviews - Atlanta, GA
Chart review experience required. Registered Nurse in state of Georgia. Experience with utilization management, coding/DRG, billing, auditing and various...

Utilization Management Nurse (Utilization Mgmt Exp.Required)...

Shared Services - Atlanta - Norcross, GA
Utilization Review, appeals, denials, managed care contracting, experienced preferred. Escalate medical review request and/or denial activities to management as...

Concurrent Review Nurse I

Peach State Health Plan - 470 reviews - Smyrna, GA
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...

Utilization Management Analyst, RN, PRN

Emory Healthcare - 325 reviews - Atlanta, GA 30322
Facilitates MD to MD reviews as needed. Maintains accurate, legible, confidential documents and records pertaining to medical reviews....
Registered Nurse (Quality Management Coordinator)
Registered Nurse (Quality Management (QM)Coordinator). Practice, ethics and resource utilization, Professional Development:....
Registered Nurse (Simulation Coordinator)
Department of Veterans Affairs - Agency Wide - Dublin, GA
$50,382 - $94,271 a year
Registered Nurse (Simulation Coordinator). Practice, ethics and resource utilization, Professional Development:....

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