Remote utilization review nurse jobs in Atlanta, GeorgiaCreate job alerts

At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. The Medica

Registered Nurse (RN) | Utilization Review Location: Atlanta, GA Agency: Compunnel Healthcare Pay: $2,200 to $2,320 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position Certificates required: GA RN licensure, BSN and Utilization Review a

Active Licensed Practical Nurse or Registered Nurse license. Support internal claims adjusting staff in the review of workers compensation claims. Review records and requests for UR received via mail, e?mail, fax, or phone.

Registered Nurse (RN) | Utilization Review Location: Atlanta, GA Agency: Lancesoft Inc Pay: $2,500 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position Department: Quality Resource Management Responsibilities performs medical necessity r

A healthcare services company in Atlanta is seeking a Review Nurse to conduct prior approval and precertification reviews for Medicaid members. The ideal candidate will have a Registered Nurse qualification with three years of clinical experience and a valid Georgia nursing license.

Registered Nurse (RN) | Utilization Review Location: Atlanta, GA Agency: Compunnel Healthcare Pay: $50 to $52 per hour Shift Information: 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position Job Title: Registered Nurse (RN) – Utilization Review (UR) Facility: Kaiser Per

Utilization Review Nurse Location: Fully Remote must reside in - TX/IL Duration: 6 months Contract (Possible Extension) Schedule: Monday – Friday, 8:00 AM – 5:00 PM. Registered Nurse (RN) with unrestricted license in state. This Position Is Responsible for Performing Accurate and Timely Medical

Experience * 3 years of RN experience in a healthcare setting; pediatrics preferred Preferred Qualifications * Bachelor of Science in Nursing * Experience in pediatrics * 2 years of experience in hospital or insurance related utilization review and/or case management * Experience with InterQual a

Registered Nurse (RN) with unrestricted license in state. Location: Fully Remote must reside in - TX/IL. This Position Is Responsible for Performing Accurate and Timely Medical Review of Claims Suspended for Medical Necessity, Contract Interpretation, Pricing; And to Initiate And/or Respond to Corre

Internal Medicine physician employment in Georgia : Fayetteville has a downtown square that has undergone a transformation process, while welcoming a variety of new businesses.As they move further into the 21st century, the efforts to retain their heritage and sense of community are stronger than ev

Part time - 2 days a weekGreat CompensationSupervise mid-level providersThis is a remote positionFor more information please contact David Smith at or email.

Specializes in review of DRG coding via medical records and attending physician's statements provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG, APR-DRG, AP-DRG, MS-DRG or TRICARE methodology and findings may be so complex and advanced t

The Telemedicine Physician role offers experienced board-certified physicians a flexible remote position to provide virtual care. Fully Remote : Deliver care through video, phone, and chat.

This is a 100% in-office based position.The Physician Credentialing and Licensing Liaison is responsible for effectively communicating and assisting between the Licensing and Credentialing Department and physician.The Physician Credentialing and Licensing Liaison ensures that all documentation which

Review medications for appropriateness. Nursing degree from an accredited college or university, or a graduate of an accredited/approved license practical nurse (LPN) program. Current and unrestricted Licensed Practical Nurse (LPN) licensure in state of practice.

The Registered Nurse, Care Line, is responsible for providing telephonic triage directional patient care advice for general and specific illnesses, health related issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families

Primary Care Physician (Full-time Remote, Telehealth). Collaborate with our integrated care team (nurse case managers, NPs, CHWs).

The registered nurse collaborates with primary caregivers and others on the interdisciplinary care plan team to provide a team approach of care. Aids in enhancing the quality and efficacy of the organization's telehealth practices and professional nursing practice through successful utilization and

Adhere to the ANA Code of Ethics for Nurses. Nurses in the Telehealth Nursing department demonstrate strong competency in using various telecommunication technologies to provide direct virtual nursing care. Licensed Practical Nurse / LPN.

Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement pol

Join the Premier Ophthalmology Practice located near BROOKS, GA A distinguished ophthalmology practice in Georgia, is currently seeking a Board-Certified/Board-Eligible Comprehensive Ophthalmologist to join our esteemed team.With over 44 years of service, we have become the largest and most experien

Job: TB Patient Management (TBPM) Developer 3.Location: Atlanta, GA (Onsite).Under broad supervision, designs, codes, tests, modifies and debugs computer software.Rebuild existing TB Patient Management (TBPM) System in a modern architecture/framework.Update TB workflows to better align with TBPM pro

Evaluating patients' medical conditions by reviewing charts.

Collaborate with physicians and nurse practitioners, experienced nurses, and a dedicated support staff to ensure comprehensive patient care. Provide exceptional virtual care, including patient assessments, medical history reviews, and appropriate medical treatment.

Conduct analysis sessions, user research, and usability reviews.

Join Oracle Health & AI, a dynamic new organization driving product development and strategy to modernize healthcare through automation and AI.As part of an innovative team you will contribute to building a world-class platform with an ambitious spirit and a focus on excellence.As a Senior Clinical

IMPORTANT: Please review the job posting and fully complete all sections of the application.

Fayetteville has a downtown square that has undergone a transformation process, while welcoming a variety of new businesses.As they move further into the 21st century, the efforts to retain their heritage and sense of community are stronger than ever.Fayetteville is located 22 miles south of downtow

Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies between the Clinical Documentation Specialist (CDS

We are looking to add 1 part time nurse to our team: If you can work any of these shifts, please apply right away!. Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.

Two or more years of outpatient clinical experience as a Physician Assistant or Nurse Practitioner, preferred but not required.

Please review the payment terms for each project.

Associate Degree in Nursing required, Bachelor's Degree in Nursing preferred Nurse Licensure Compact required Michigan and Illinois Nurse Licensure required within 90 days of hire, ability to obtain additional licenses as requested by the organization within 90 days of hire Basic Life Support (BLS)

Evaluating patients' medical conditions by reviewing their charts.

The Preadmission Nurse (PAT RN) has the responsibility for organizing and directing activities in accordance with nursing standards, JC, Medicare and all other applicable federal, state and local guidelines. PAT RN may assume the following PAT responsibilities: contact, by way of telephone, all pati

Regularly communicate OCS utilization activities and users' feedback. Timely submission of post case documentation and preparation/presentation of case reviews.

Job Title: Care Review Clinician Location: Remote 100% (Must reside in Florida) Duration: 03+ months (Possibility of extension). Job Description: Must reside in Florida however this is fully remote preference is for a LMHC, LMFT, or LCSW however RN with behavioral health outpatient experience will b

Pediatric Phone Triage Nurse (LPN/RN). This position is a great fit for a nurse who enjoys patient interaction, thrives in a fast-paced environment, and is skilled at providing clear guidance over the phone.

Please review the payment terms for each project.

Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and be

Licensed Practical Nurse (LPN) – Full Time. Are you a compassionate, dedicated nurse ready to elevate your career in a community that values person-centered care, teamwork, and professional growth? St. Collaborate with experienced nurses, CNAs, and healthcare professionals who care about your succ

Registered Nurse - The Registered Nurse is responsible for performing nursing activities to care for and treat individuals in accordance with the policies of InCommunity dba Georgia Community Support and Solutions, Inc (GCSS) and the State of Georgia Nursing Licensing Bureau. Review MARS and other n

The virtual nursing staff nurse uses nursing processes and telemedicine technology to remotely assess, plan, implement, and evaluate care for patients. The virtual nursing staff nurse functions within the framework of the policies and procedures of the organization and demonstrates professional grow

Maintain active cases during open enrollment and premium review periods to support revenue and program growth. Perform advanced document review, case status identification, basic legal research, and escalate issues when necessary.

Amedisys - 1990 Lakeside Parkway Suite 240 [Health Worker / Caregiver] As a Home Health Aide at Amedisys, you'll: Obtain temperature, pulse, blood pressure and respiration; Maintain a clean, safe, and healthy environment; Assist patient with getting in and out of bed, bathing, hygiene, and toileting

Review medical records for accuracy, completeness, and policy compliance; verify patient demographic and personal information. After you apply online and submit your resume, a member of our recruiting team will review your qualifications and experience.

Step forward and have your resume reviewed for Lead Data Manager positions across various teams, allowing us to find the project and client environment that best suits your experience and interests!. This is a remote work-from-home position, and all necessary equipment will be provided. Fully remote

About the job Medical Records Specialist - Remote.