Hybrid Review Nurse - Prior Authorization & UM (Medicaid)
Alliant Health Group
Alliant Health Group in Atlanta, Georgia, is seeking a Hybrid Review Nurse for its Prior Authorization and Utilization Management team. This role conducts prior approval and precertification reviews for Georgia Medicaid members. The ideal candidate will have a current Georgia nursing license and at least three years of recent clinical experience. We offer competitive benefits such as medical, dental, and retirement plans, along with a commitment to work/life balance and employee well-being. #J-18808-Ljbffr Alliant Health Group
Vacancy posted 6 days ago
Similar jobs that could be interesting for youBased on the Hybrid Review Nurse - Prior Authorization & UM (Medicaid) in Atlanta, GA vacancy
- ...Description Are you a bedside nurse seeking a change from the... ...! Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management (PA/UM) team. The Review Nurse conducts... ...for Georgia Fee-for-Service Medicaid members for the team’s...SuggestedContract work
Alliant Health Solutions, Inc.
Atlanta, GAmore than 2 months ago - ...seeks a Medical Clinician-Pediatrician to provide expert clinical review for data concerning structural birth defects. The ideal... ...experience in pediatrics, public health, or epidemiology. This hybrid role includes responsibilities such as mentoring clinicians and...Suggested
- ...The Role The Intake Nurse serves as the clinical gatekeeper... ...Key Responsibilities Review incoming referrals,... ...meet Medicare, Medicaid, managed care, private duty... ...participation, and payer authorization requirements. Assist with prior authorization clinical documentation...SuggestedFull timeWork experience placementWork at office
$29 - $52 per hour
...Registered Nurse Clinical Annotator At UnitedHealthcare, we'... ...designed to streamline and automate prior authorization processes in healthcare. This... ...Primary Responsibilities: Review medical records and interpret... ...utilization management (UM) guidelines Contribute to...SuggestedRemote jobHourly payMinimum wageFull timeWork experience placementLocal area- ...worker's compensation, Medicare, Medicaid and managed care patients for... ...provider service eligibility, prior to registration as applicable.... ...of insurance benefits and when authorization may be required per payor requirements, able to review insurance benefits with patient...SuggestedReliefWork at officeLocal area
$43.5k - $48k
...casualty and estate functions involving state Medicaid beneficiaries or deceased Medicaid... ...responsible for the intake, maintenance, claims review, case management, settlement, and all... ...What you should expect in this role • Hybrid work arrangement based in the Tucker, GA...Full timeContract workWork at officeMonday to FridayFlexible hours2 days per weekGainwell Technologies LLC
Tucker, GAmore than 2 months ago- ...This position will be working a hybrid schedule that consists of days... ...accurately and efficiently. Prior experience in a similar role is... ...s). Areas Of Responsibility Review and organize patient medical... ...Medical Assistant (CMA) or licensed nurse (i.e. LPN or RN). Must be...Full timeRemote workMonday to FridayFlexible hours
- ...of varying licensure status, Assessors, Paraprofessionals, Nurses & other therapy providers. We are actively growing and... ...assessment documentation, physical assessments/vitals, medication review and prior authorization (PA) form completions. The Nurse also will manage,...Full timeWork from homeMonday to Friday
Family Ties Inc
Atlanta, GA13 days ago - ...Registered Nurse Utilization Review - Managed Care Travel Exclusive Compact State Registered Nurse - Utilization Review Clinic 3495 PIEDMONT RD. NE., Atlanta, Georgia 30305 Weekly Pay * $ 2,778 - $ 2,950 8 D Aug 03, 2026 13 Wks 1 Position 40 Hrs/wk...Hourly payWeekly payExtra incomeTemporary workLocal areaWeekend work
- Role Snapshot The Appeals Nurse examines medical... ...redeterminations are medically reviewed as needed and completed... ...Benefits Remote and hybrid work options available... ...Centers for Medicare & Medicaid Services (CMS) contract... ...fingerprinting prior to being granted access...Contract workFor contractorsLocal areaImmediate startRemote work
- ...Outpatient services include behavioral health, nursing, and psychiatric assessment,... ...completing patient assistance applications and prior authorizations as needed. Records all care... ...we encourage you to apply. We promptly review all applications. Highly qualified candidates...Full timeTemporary workFlexible hours
$46k
...referrals are processed accurately, authorizations are obtained when required,... ...Management Receive, review, and process incoming and outgoing... .... Obtain and document prior authorizations as required.... ...with commercial, Medicare, and Medicaid insurance. Epic experience...Seasonal workWork at officeImmediate startMorehouse School of Medicine
Atlanta, GA2 days ago$50 - $55 per hour
...travel around the Atlanta metro area Setting: Hybrid, including work-from-home and client home... ...clinical documentation and oversee chart reviews Assist with credentialing and quality... ...Graduate of an accredited nursing program; BSN preferred Current Registered...Hourly payDaily paidWork at officeLocal areaMonday to FridayFlexible hoursDay shiftAfternoon shift- ...promote excellence in customer serviceAdministrative tasks, prior authorizations, etc.Skills & Qualifications:Strong phlebotomy skillsCompletion... ...to join our team!How To Get Started:To have your resume reviewed by someone on our Talent Acquisition team, click on the "Apply...Full timeWork at officeImmediate startMonday to Friday
Shady Grove Fertility
Atlanta, GA5 days ago $18 - $24 per hour
...Regular, Full-time Reports to: Nurse Manager Pay Range: $18-$24 Department... .... Assists in coordination of prior authorizations and other pharmacy support. Assists... ...Uses a structured framework to manage, review and identify learning from patient complaints...Hourly payFull timeWork at officeLocal area26 Health,Inc
Atlanta, GA16 days ago- ...experienced Registered Nurse looking for a new... ...Daily Responsibilities Review admissions through on-... ...Data enters assessments, authorizations and reviews into the... ...environment Qualifications Prior Authorization... ...experience (Medicare, Medicaid, commercial) Additional...Private practiceMonday to Friday
- ...Registered Nurse (RN) - Hospice Care The Registered Nurse (RN)... ...least monthly. Perform ongoing review and follow-up on assigned... .... Must supervise Aides. Prior to providing care independently... ...regulatory guidelines (i.e., Medicare, Medicaid, ACHC, and human resource...ReliefInternship
Talent Software Services
Atlanta, GA2 days ago - ...provider with an array of services: Skilled Nursing, Personal Care Services, Companionship... ...members receiving homecare services. Reviewing referrals, evaluating the member’s... ...Supervisory visits are not billable through Medicaid. QUALIFICATIONS: A current Georgia...
Primecare Home Care Services Inc
Atlanta, GA4 days ago $2,283 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Atlanta, GA Agency: Atlas MedStaff Pay: $2,283 per week Shift... ...Great Recruiters. Both of those recognitions are fueled by real reviews by real travel nurses and allied healthcare professionals that...Hourly payFull timeContract workWork at officeRemote workShift workNight shiftWeekend workTravelNurseSource
Atlanta, GA2 days ago$1,352 - $1,501 per week
...Registered Nurse (RN) | Wound/Ostomy Location: Atlanta, GA Agency: Host Healthcare Pay: $1,352 to $1,501 per week Shift... ...was rated #1 in Nursing Satisfaction by MIT Sloan Management Review. No matter if you want to explore the other side of the country...Full timeContract workLocal areaImmediate startShift workTravelNurseSource
Atlanta, GA2 days ago$1,720 - $1,873 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Atlanta, GA Agency: Host Healthcare Pay: $1,720 to $1,873 per week... ...was rated #1 in Nursing Satisfaction by MIT Sloan Management Review. No matter if you want to explore the other side of the country...Full timeContract workLocal areaImmediate startShift workNight shiftTravelNurseSource
Atlanta, GA2 days ago$1,772 per week
...Registered Nurse (RN) | Wound/Ostomy Location: Atlanta, GA Agency: Magnet Medical Pay: $1,772 per week Shift Information... ...in quality improvement initiatives, such as audits, peer reviews, and training, to improve the quality of wound care services provided...Full timeContract workShift workMagnet Medical
Atlanta, GA2 days ago$23 - $25 per hour
...Assist providers with examinations and in-office procedures. Review provider-approved preparation instructions for colonoscopies... ...point-of-care testing. Support prescription refills and prior authorizations as directed. Maintain accurate documentation in the...Hourly payFull timeWork at officeDay shiftCornerstone Staffing Solutions Inc
Atlanta, GA11 days ago- ...direct supervision of a licensed nurse in accordance with... ...therapy. Obtain vital signs prior to reinfusion; perform all relevant... ...accurate and timely manner. Review treatment sheets for completeness... .... Must meet Center for Medicaid/Medicare Services (CMS)-approved...Immediate startRemote work
Fresenius Medical Care
Decatur, GA1 day ago - ...Registered Nurse -INTAKE ADMISSIONS- UNSKILLED SUPERVISORY VISITS IN FULTON COUNTY 3031... ...is a Private Home care Agency Providing Medicaid-approved, skilled and unskilled nursing care... ...prescribed by the attending physician. Reviews all plans of treatments for accuracy, appropriateness...Hourly payPart time
- ...prospective patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization... ...preferred Preferred Qualifications ~ Bachelor of Science in Nursing ~ Previous experience with MCG and/or InterQual systems ~2...ReliefRemote workWeekend work3 days per week
- ...RN, Specialty Care Review On Call PRN Responsible for carrying out medical necessity reviews on all designated referrals for Home... ...Qualifications: Experience ~ Minimum three (3) years of clinical nursing OR completed Kaiser Permanente Nurse Residency Program in KP...Contract workReliefWork at officeLocal areaImmediate startWeekend work
$2,097 - $2,231 per week
...Registered Nurse (RN) | Post-Anesthesia Care Unit (PACU) / Pre-Post Op Location: Decatur... ...Op RN ensures patient safety and comfort prior to and during the surgical recovery... ...Assess patients pre-operatively, including reviewing medical history, performing physical examinations...Full timeContract workTemporary workShift workTravelNurseSource
Decatur, GA1 day ago$1,303 - $1,453 per week
...Registered Nurse (RN) | Medical-Surgical Location: Atlanta, GA Agency: Host Healthcare Pay: $1,303 to $1,453 per week... ...that was rated #1 in Nursing Satisfaction by MIT Sloan Management Review. No matter if you want to explore the other side of the country...Full timeContract workLocal areaImmediate startShift workTravelNurseSource
Atlanta, GA2 days ago$1,642 per week
...Registered Nurse (RN) | Bone Marrow Transplant Location: Atlanta, GA Agency: Magnet Medical Pay: $1,642 per week Shift... ...multidisciplinary meetings, case discussions, and rounds to review and enhance patient care. # Requirements Required for Onboarding...Full timeContract workShift workNight shiftMagnet Medical
Atlanta, GA2 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Hybrid Review Nurse - Prior Authorization & UM (Medicaid). Be the first to apply!
Related searches
- medical prior authorization specialist Atlanta, GA
- prior authorization Atlanta, GA
- prior authorization nurse work from home Atlanta, GA
- remote prior authorization Atlanta, GA
- prior authorization nurse Atlanta, GA
- remote prior authorization pharmacist Atlanta, GA
- prior authorization specialist Atlanta, GA
- prior authorization coordinator Atlanta, GA
- prior authorization pharmacist Atlanta, GA
- prior authorization manager