RN - Utilization Management
Piedmont
Overview Experience the advantages of real career change Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future. Responsibilities 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 and meet medical necessity for continued stay. This role ensures that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services. Qualifications Education Graduate of an accredited nursing school Required Bachelor's Degree of Science in Nursing Preferred Master's degree Preferred Work Experience 2 years of experience in an acute, post-acute or payer setting Required 3 years of utilization review or care management experience Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required Business Unit : Company Name: Piedmont Healthcare Corporate #J-18808-Ljbffr
- Piedmont Healthcare Corporate is seeking an RN to ensure appropriate level of care for acute hospital admissions, monitor... ...degree is a plus. Two years of relevant experience are expected, with utilization review or care management experience valued. #J-18808-Ljbffr PiedmontSuggested
- ...Experience 2 years of experience in an acute, post-acute or payer setting Required 3 years of utilization review or care management experience Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required...SuggestedWork experience placement
$2,250 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Atlanta, Georgia. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: ASAP ~ Duration: 13 weeks...SuggestedTemporary workImmediate startShift work- A leading healthcare staffing agency in Atlanta is seeking a qualified Registered Nurse to join their team. This role involves reviewing patient admissions, providing clinical resources, and entering data into the system. The position offers a competitive salary and benefits...SuggestedMonday to Friday
- ...is an extension of the Clinical Services management and leadership team with responsibilities... ...direct care responsibilities consistent with RN Senior for the role as assigned. Job... ...assigned patient care and treatments provided. Utilizes knowledge and resources regarding...SuggestedFull timeTemporary workWork at officeMonday to FridayFlexible hoursNight shift
- ...clinical care and support. Care aspects include assessment, clinical management, communication, crisis prevention, regulatory readiness, and... ...delivery through a culturally sensitive process. Utilize clinical decision support tools and resources to recognize issues...Shift work
- Cross Country Nurses is looking for a travel nurse RN Utilization Review for a 14-week assignment in Atlanta, Georgia. This role entails... ...MCG and LCD criteria. Candidates must have prior utilization management experience and bring their license on the first day. The position...Day shift
- ...Job Description Job Description Job title: Utilization Review Shift: 09:30 AM to 08:00 PM 13 weeks contract Description: Utilization Review RN - Target Review Health Plan Insurance (no acute care) BLS (AHA) RN state license \nCompany Description...Contract workShift work
$1,634 per week
...Registered Nurse (RN) | Medical-Surgical Location: Atlanta, GA Agency: FlexCare Pay: $1,634 per week Shift Information... ...leader in travel nursing, allied health, and therapy talent management solutions for top healthcare facilities throughout the U.S....Full timeContract workImmediate startShift work$1,984 per week
...Registered Nurse (RN) | Administration / Management Location: Atlanta, GA Agency: Advantis Medical Staffing Pay: $1,984 per week Shift Information: Nights - 3 days x 12 hours Contract Duration: 13 Weeks Start Date: 8/10/2026 About the Position...Full timeContract workImmediate startShift workNight shift$1,894 - $2,094 per week
...Registered Nurse (RN) | Administration / Management Location: Atlanta, GA Agency: Titan Medical Group Pay: $1,894 to $2,094 per week Shift Information: Nights - 3 days x 12 hours Contract Duration: 13 Weeks Start Date: 8/31/2026 About the...Weekly payFull timeContract workShift workNight shift$1,894 - $2,094 per week
...Registered Nurse (RN) | Administration / Management Location: Atlanta, GA Agency: Titan Medical Group Pay: $1,894 to $2,094 per week Shift Information: Nights - 3 days x 12 hours Contract Duration: 13 Weeks Start Date: 8/31/2026 About the...Weekly payFull timeContract workShift workNight shift$1,984 per week
...Registered Nurse (RN) | Administration / Management Location: Atlanta, GA Agency: Advantis Medical Staffing Pay: $1,984 per week Shift Information: Nights - 3 days x 12 hours Contract Duration: 13 Weeks Start Date: 8/10/2026 About the Position...Full timeContract workImmediate startShift workNight shift- ...Job Description As an RN Care Manager with VillageMD, you will help us achieve our goals by collaborating with providers and engaging... ...improve management of overall health and reduce unnecessary utilization Utilizing your clinical knowledge and deep understanding...Work at officeFlexible hours
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and to assess member needs to help them live healthier lives. You will collaborate with clinicians, interpret plans of care, and support discharge planning while...Remote jobWeekend work
- ...Job Description Job Description RN Supervisor Mon. – Fri. Full time $10,000... ...s by assessing, planning, delegating and utilizing independent judgment in directing staff to... ...skills ~ Strong organization and time management skills ~ Comply with current federal, state...Full timeLocal areaRelocation packageMonday to Friday
- ...Description Job Description MDS Director- RN Top pay and benefits! Who we are... .... In this essential role, you will manage all aspects of the Minimum Data Set (MDS)... ...meetings including: daily PDPM, weekly CMI, Utilization Review, monthly Triple Check, and care plan...
- ...marked with * are preferred Work Settings: Acute Hospital Long Term Acute Care/Rehab/Skilled Nursing Case Management/Utilization Review: Admission Criteria Care coordination Discharge Planning Utilize InterQual Criteria Utilize Milliman...Night shiftWeekend work
- ...holidays ~ Employee centered patient focused organization RN Case Manager The registered nurse plans, organizes and directs hospice... ...hospice needs. Provides professional nursing care by utilizing all elements of nursing process. Assess and evaluate patient...Weekly pay
- ...families. The Visit Nurse works in conjunction with the Nurse Case Manager, Director of Nursing (DON) and the Interdisciplinary Team to:... ...patient, attending physician and the Interdisciplinary Team, utilizing pharmacological and non-pharmacological methods of pain/symptom...
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and patient plans of care. The role offers remote work from anywhere in the U.S., with weekend coverage on a rotating basis and a salary range based on experience...Remote jobWeekend work
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and to identify solutions that help members... ...with Medical Directors to improve care progression. A RN license is required and weekend work is expected approximately...Remote jobWeekend work
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services, assess member needs, and identify plans of... ...offering remote work within the U.S. The position requires an RN license, 3+ years of hospital nursing experience, and...Remote job
$25k
...Field Care Manager Nurse 2 The Clinical Care Nurse (RN) is a clinic-based nursing role focused on improving patient outcomes. You will support safe Transitions of Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage Stars and quality performance...Work at officeMonday to Friday- ...OverviewThe Case Manager (PRN) position at Critical Illness Recovery Hospital requires a... ...right.The Case Manager is responsible for utilization reviews and resource management, discharge... ...a clinical discipline either as a Nurse (RN /LPN/ LVN) or a Respiratory Therapist OR...ReliefShift workWeekday work
$63.84k - $100.8k
...Anticipated End Date: 2026-09-03 Position Title: Telephonic RN Nurse Case Manager I - AmeriBen Job Description: Telephonic RN Nurse Case... ..., Skills and Experiences: Previous experience with utilization review and/or prior authorization. Clinical case management...Full timeTemporary workWork experience placementWork at officeLocal areaMonday to FridayDay shift1 day per week$25k
...caring community The Clinical Care Nurse (RN) is a clinic-based nursing role focused... ...of Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage Stars and... ...activate patients are chronic disease self-management, particularly in DM, HTN, CHF and COPD....Full timeTemporary workApprenticeshipWork at officeMonday to Friday$25k
...community The Clinical Care Nurse (RN) is a clinic-based nursing role focused... ...Transitions of Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage Stars and... ...patients are chronic disease self-management, particularly in DM, HTN, CHF and COPD....Full timeTemporary workApprenticeshipWork at officeMonday to Friday- ...include coordinating daily operations, staffing, case flow, and management of inventory, instruments, supplies and equipment for... ...relationships and building rapport with physicians to ensure continued utilization of the specialty. Responsibilities also include functioning...Temporary workWork at officeShift work
- Emory Healthcare is seeking an RN Clinician to provide high-quality patient care within our multidisciplinary teams. The role emphasizes utilization of the AACN Synergy Model, delivery of safe nursing care, and patient- and family-centered planning. You will collaborate...
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