RN Clinical Denials & Utilization Specialist
Northside Hospital Inc.
Northside Hospital Inc. in Atlanta is seeking a dedicated nurse with a strong clinical case management experience to join our team in a Utilization Management role. The ideal candidate will process clinical denials and support the design of data collection methodologies. The position requires a graduate of an accredited nursing school and three years of relevant experience. This is an excellent opportunity for healthcare professionals looking to advance their careers in a state-of-the-art environment. #J-18808-Ljbffr Northside Hospital Inc.
- Northside-Hospital-Inc. seeks a qualified candidate for the Utilization Management position in Atlanta, GA. This role focuses on processing clinical denials and implementing data collection methodologies to enhance patient care quality. The ideal applicant will be a graduate...Suggested
- ...Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary... ...review process, aids in denial prevention, and serves as resource...SuggestedReliefRemote workShift work3 days per week
- ...possibilities of a career at Northside today. Responsibilities Processes, tracks and appeals clinical denials. Supports and facilitates the design, development and implementation of Utilization Management data collection methodologies and studies in the respective functional...SuggestedWeekend work
- ...reimbursement rates are paid on claims based on current client contracts. Utilizes knowledge of the revenue cycle and patient accounts to maximize... ...Knowledge of healthcare receivables and collections, including denial and appeal processes. Understanding of the healthcare revenue...SuggestedWork at office
$39.31 per hour
...more Description We are seeking a capable Cardiac Device Specialist who has acquired broad experience in caring for patients and... ...to tailor device function and programming to each individual clinical situation. This position may include in-patient and out-patient...SuggestedHourly payFull timeLocal areaRemote work- ...a graduate of an accredited school of nursing Licensed as a RN in the State of Georgia in good standing without limitations.... ...Additional Life Support credential (ACLS, PALS, NRP, etc.) or other clinical specialty certifications in specific units. Visual color acuity...Night shiftWeekend work
- ...following week. Experience ~12 months RN experience required; pediatrics preferred... ...Science in Nursing Previous pediatric clinic experience Education ~ Graduation... ...a culturally sensitive process. Utilizes clinical decision support tools and...Part timeMonday to FridayShift work3 days per week
- ...Heart Association within 30 days of employment or upon start of clinical shift if working in the Emergency Department (ED) Pediatric... ...healthcare delivery through a culturally sensitive process. Utilizes clinical decision support tools and resources to recognize issues...Monday to FridayShift work
- ...Clinic Nurse At Marcus Autism Center Children's is one of the nation's leading children... ...of Science in Nursing ~1 year of RN experience; pediatrics preferred ~ Previous... ...quality. Engages in ethical practices utilizing principles from The Code of Ethics for Nurses...
- ...RN - Transplant Clinic The staff nurse provides nursing care to patients from birth through the lifecycle utilizing nursing processes to assess, plan, implement, and evaluate the care for patients. He/she functions within the framework of the policies and procedures...Work experience placementRelief
- ARMStaffing is looking for a travel nurse RN Float ED for a critical role in the Emergency Department in Atlanta, Georgia. This position... ...a travel contract of 13 weeks with health benefits, flexible scheduling, and a supportive clinical team. #J-18808-Ljbffr ARMStaffingContract workFlexible hours
- A healthcare services company is seeking a Home Infusion IVIG RN for a fully remote position providing patient care in the Atlanta,... ...balance. Ideal candidates should be registered nurses with strong clinical skills, a valid Georgia RN license, and a passion for patient-...Remote job
- A healthcare provider in Atlanta is looking for a Staff RN III to demonstrate clinical competence and provide high-quality patient care. The ideal candidate must be a graduate of an accredited nursing school and hold an RN license in Georgia. Responsibilities include managing...
- ...Certification as required by department Continuous employment as a Clinical Nurse 3 at Children's Healthcare of Atlanta since March 2017... ...for patient care quality. Engages in ethical practices utilizing principles from The Code of Ethics for Nurses. Maintains...
- A leading Managed Geospatial Services provider in Atlanta seeks a Utility Coordinator responsible for leading coordination across transportation projects. This role involves liaising between departments and utility owners, preparing detailed reports, and ensuring compliance...Local area
- ...searching for an Prior Authorization Specialist to join its team in Smyrna, GA . We... ...documentation of all approvals and denials, and transferring all clinical questions and judgment calls to the... ...volume from inception to delivery utilizes appropriate courteous and...
- Clinical Practice Special RN - Clinical Operations - FT Grady Health System offers many career paths... ...Grady! SUMMARY The Clinical Practice Specialist RN supports and promotes the mission... .... Facilitates positive change utilizing principles of change and organizational...
$51.31 - $78.76 per hour
Pay Range: CLINICAL RN- $51.31 to $78.76 Job Summary The EmPATH Unit Registered Nurse is responsible for delivering safe, compassionate... ...individuals experiencing acute psychiatric or behavioral health crises. Utilizing the nursing process, the RN independently assesses, plans,...- Humana Inc is seeking a Utilization Management RN based in Atlanta, Georgia. This role involves collaborating with healthcare providers to evaluate... ...must hold an active RN license, have over 5 years of clinical experience, and be available for weekend on-call rotations...Remote jobWeekend work
- A leading engineering firm in Atlanta, GA is seeking a Part-Time Utility Coordinator to support transportation projects. This role involves managing utility coordination efforts and serving as a liaison between designers and utility agencies. Ideal candidates will have...Part time
- A healthcare services organization seeks a Utilization Management Representative I to manage incoming calls and claims work. This role enables virtual work with flexibility, focusing on customer relations and authorization processes. Candidates must have a high school diploma...Remote job
- ...RESPONSIBILITIES Demonstrates competency in clinical practice; self-directed in goal setting... ...of complex patients and families; utilizes the nursing process and is skilled at adapting... ...accredited school of nursing Licensed as a RN in the State of Georgia in good standing...Immediate startWeekend work
- ...OR has service lines of responsibility regarding patient care utilizing the nursing process. The Team Lead will demonstrate expertise as... ...and serves as liaison as applicable with physicians, anesthesia, clinics, and staff. Maintains clinical operations, equipment,...Flexible hours
- ...RN Clinical Educator- CVOR Overview: Serves as clinical expert providing education, research, coaching, direct care, consultation,... ...staff. Serves as a change agent and promotes quality through the utilization of clinical expertise. Provides clinical care as needed when...Work experience placement
- At Parexel, we are a leading Clinical Research Organization (CRO) company specializing in delivering life- changing medicines to patients... ...the Senior Manager, Project Planning and Support, the Project Specialist (Coordinator) position is a US home-based position, ideally...Remote workWork from home
- ...faculty position in the Department of Ophthalmology specializing in cornea and external disease. The successful candidate will provide clinical care, perform corneal transplants, and engage in teaching medical students and residents. This role offers opportunities for...Remote work
- ...RN Clinical Educator- CVOR Overview: Serves as clinical expert providing education, research, coaching, direct care, consultation,... ...staff. Serves as a change agent and promotes quality through the utilization of clinical expertise. Provides clinical care as needed when...Work experience placement
- ...pace, we're here to support you. This role allows you to stay clinically engaged without sacrificing balance, connection, or continuity... ...patients. Commitment to Continuing Education: Commitment to utilize available resources of continuing education and to facilitate...Full timePart timeLocal areaFlexible hoursShift work
$140k - $160k
...Hospital Manager and Regional Manager. Cumberland Animal Clinic in Smyrna, Georgia we're not just a clinic, we're a family. If... .... Commitment to Continuing Education: Commitment to utilize available resources of continuing education and to facilitate learning...Local areaRelocation$42 per hour
...cutting-edge treatments with deep clinical expertise and genuine... ...advanced practitioner orders. Utilizing available software, documents... ...practitioners regarding approval or denial. Communicates approvals and... ...Active Registered Nurse (RN) license in the state of GA....Hourly payFull time
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Clinical Denials & Utilization Specialist. Be the first to apply!
- neuro icu registered nurse Atlanta, GA
- new grad rn Atlanta, GA
- nicu rn Atlanta, GA
- registered nurse nursing home Atlanta, GA
- new grad rn residency Atlanta, GA
- rn observation unit Atlanta, GA
- rn hospice Atlanta, GA
- outpatient registered nurse Atlanta, GA
- rn evening shift Atlanta, GA
- home health rn case manager Atlanta, GA

