Expired Utilization Management Nurse jobs in Atlanta, GA
Atlanta, GA
$22,406-$190,477/year (est.)
Overview Guidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges...
Elevance Health
Atlanta, GA
$22,444-$190,477/year (est.)
Utilization Management Rep Lead Job Family: Customer Care Type: Full time Date Posted:Apr 04, 2023 Req #: JR63603 Location: National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint Description Responsible for performing customer service in a sales/account...
Elevance Health
Atlanta, GA
$70K-$86K / yr. (est.)
Utilization Management Representative III Location: Remote - the ideal candidate lives within 50 miles of a Pulse Point location. The Utilization Management Representative III is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact:...
Atlanta, GA
$22,444-$190,477/year (est.)
Description RESPONSIBLE FOR: The purpose of the Utilization Management Team Lead is to provide hands-on leadership of a specific care team in order to provide direct oversight to both Utilization Management Nurses and Utilization Management Assistants under the direction of the Utilization...
Atlanta, GA
$22,406-$190,477/year (est.)
Overview How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar,our mission is simple, yet powerful:to enhance the health and well-being of every person we serve. We are...
Elevance Health
Atlanta, GA
$69K-$85K / yr. (est.)
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card,...
Atlanta, GA
$22,444-$190,477/year (est.)
Description SHIFT: Day Job SCHEDULE: Full-time Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we...
Atlanta, GA
$22,406-$190,477/year (est.)
The Opportunity We're looking for a Remote Utilization Management Rep , working in the Insurance industry in Atlanta, Georgia . Handle at least 70 inbound non-case generating calls or prior-authorization statuses. Act as a liaison between hospital, health plans, physicians, patients, vendors and...
Atlanta, GA
$57,486-$95,810/year (est.)
UM (Utilization Management) experience is REQUIRED. Ideal candidates: Will have a few years of Major payor experience, InterQual or similar experience required Payor Utilization Management experience is required Comfortable working PST Hours Comfortable obtaining their CA license Experience working...
Atlanta, GA
$22,444-$190,477/year (est.)
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require...
Atlanta, GA
$22,444-$190,477/year (est.)
Description The Clinical Business Lead works as liaison between vendors and organization. The Business Clinical Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities Location: preference is Office base in Louisville, willing to consider out of...
Atlanta, GA
$58K-$114K / yr.
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The UM Nurse provides utilization management services, in...
Atlanta, GA
$22,406-$190,477/year (est.)
Essential Functions: Telephonically reviews medical information in order to determine the medical necessity of continued stay according to review standards. Determines whether treatments are consistent with member's diagnosis and appropriate level of care. Uses critical thinking to determine if...
Atlanta, GA
$22,406-$190,477/year (est.)
Qualifying candidates may be eligible for a sign on bonus of up to $5,000Fully remote position. Work anywhere in the U.S.Schedule: 5 days per week 10:30a-7:00p ESTOR4 days per week with variable 10 hours shifts between 830a-830p ESTUtilizes clinical skills to coordinate, document and communicate...
Elevance Health
Atlanta, GA
$56K-$68K / yr. (est.)
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card,...
Atlanta, GA
$62K-$75K / yr. (est.)
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its...
Atlanta, GA
$57,207-$95,344/year (est.)
JOB SCHEDULE: PRN RESPONSIBLE FOR: The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of...
Atlanta, GA
$22,406-$190,477/year (est.)
Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or providing health management program interventions. Utilizes clinical proficiency and...
Atlanta, GA
$56K-$68K / yr. (est.)
Alliant Health Group is a family of companies that provides professional services supporting the effective administration of healthcare programs and funding to support healthcare improvement initiatives. Alliant Health Solutions provides Federal and state government entities with the services,...
Atlanta, GA
$22,444-$190,477/year (est.)
Req ID: 48420BR POSITION SUMMARY This position is with American Health Holding, an Aetna company. The UM Nurse utilizes clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program. The hours for this position are 11:30-8PM ET. This is a...
Centerwell
Atlanta, GA
$22,406-$190,477/year (est.)
Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied and frequently require...
Atlanta, GA
$70K-$96K / yr.
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 coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2...
Atlanta, GA
$58K-$114K / yr.
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The UM Nurse provides utilization management services, in...
Elevance Health
Atlanta, GA
$62K-$111K / yr.
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card,...
Atlanta, GA
$22,444-$190,477/year (est.)
Description RESPONSIBLE FOR: The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This roles monitors that the patient is progressing in their plan of care...
Atlanta, GA
$22,406-$190,477/year (est.)
Why Wellpath Here at Wellpath, everything that we do is about taking care of people – our patients, our staff and our partners. We are committed to making a difference by providing hope and healing to vulnerable patients in challenging clinical environments. Our talented, compassionate team thrives...
Atlanta, GA
$57,486-$95,810/year (est.)
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come...