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- ...Work and Healthiest Employer", seeks a Review Nurse. The Review Nurseconducts prior approval... ...review decisions or cases requiring physician clarification Participate in quality... ...Georgia nursing license required Preferred: Utilization Review or Prior Approval...SuggestedContract work
$29.05 - $67.97 per hour
...for medical claim and internal appeals review activities - ensuring alignment with applicable... ...Resolves escalated complaints regarding utilization management and long-term services and... ...for utilization management, CMOs, physicians and member/provider inquiries/appeals....SuggestedHourly payWork experience placementWork at officeRemote workMolina Healthcare
Decatur, GA18 hours ago$2,640 per week
...Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 03/15/2026 ~ Duration: 12 weeks ~4...SuggestedPrivate practiceShift workCross Country Nurses
Atlanta, GA18 hours ago$37.89 - $47.49 per hour
...precertification and medical necessity reviews on all designated referrals as well as targeted... ...admissions, as well as referrals, utilizing established criteria and guidelines, retrospective... ...criteria to the appropriate review physician. Performs questionable benefit and...SuggestedPermanent employmentFull timeContract workWork at officeLocal areaShift workKaiser Permanente
Atlanta, GA4 days ago- A healthcare services company in Atlanta is seeking a Review Nurse to conduct prior approval and precertification reviews for Medicaid members. The role involves evaluating clinical information, documenting decisions, and collaborating with team members. The ideal candidate...Suggested
- ...Job Title: Nurse Practitioner/Physician assistant - Home Health Risk Assessments... ...with occasional on-site training) Review patient records for past and present health... ...navigating different software, typing) and utilizing websites to perform required duties...SuggestedFull timeImmediate start
The Judge Group
Decatur, GA4 days ago - ...oriented Family Medicine or Internal Medicine Physician to join our team. Here, you can focus on... ...high-quality, measurable outcomes. Review all labs and clinical documents promptly... ...medical record within 72 hours, utilizing technology and systems efficiently to maintain...SuggestedHourly payFull timeImmediate startMonday to FridayFlexible hoursWeekend workWeekday work
AllCare Georgia
Decatur, GA1 day ago $76k - $85k
A public sector solutions firm is seeking a Utilization Review Nurse to perform medical management and review tasks in a remote capacity. The ideal candidate will have at least 2 years of clinical nursing experience and must possess effective communication and organizational...SuggestedRemote job$29.05 - $67.97 per hour
...Join our dedicated team as a Nurse Reviewer, where you will play a crucial role in... ...Address escalated complaints concerning utilization management and long-term services and supports... ...for utilization management, CMOs, physicians, and address member/provider inquiries....SuggestedHourly payWork experience placementWork at officeMolina Healthcare
Atlanta, GA14 hours agonew$76k - $85k
...challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for utilizing a medical management software system on a day-to-day...SuggestedFor contractorsH1bWork at officeLocal areaRemote work- ...and assist them in effective delegation utilizing the Synergy model for care. Considered... ...in preparation of regulatory agency reviews. Assists in administrative activities... ...network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties...Suggested
Emory Health Care
Jonesboro, GA18 hours ago $46.31 per hour
...staff and facilitates communication with physicians and internal administrators to provide... ...and assist them in effective delegation utilizing the Synergy model for care. Considered an... ...daily operations. 4. Completes performance reviews with Nurse Manager input as appropriate....SuggestedHourly payFull timeLocal areaShift workEmory Healthcare/Emory University
Decatur, GA18 hours ago- ...appropriate Acts as a referral source for staff, families, physicians on services and equipment related to rehabilitation services.... ...complete responsibilities in an appropriate and timely manner. Utilizes materials and equipment in a safe and cost-effective manner....SuggestedReliefShift work
Wellstar Health Systems, Inc.
Marietta, GA2 days ago - ...patients, families, caregivers, and referring physicians to assist with accessing clinical and... ...patient/family advocacy with day-to-day review and coordination of multidisciplinary... ...the specialty patient population to be utilized by both the patients and the healthcare...SuggestedWork at officeLocal area
Kaiser Permanente
Atlanta, GA18 hours ago - ...care to a patient population independently utilizing the nursing process. Demonstrate... ...for a patient population based on receipt/review of evidence-based research. Includes... ...network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties...SuggestedFull time
Emory Healthcare
Decatur, GA2 days ago - ...judgment, ingenuity, and initiative in the utilization of the equipment for the diagnosis and/... ...marker are utilized appropriately. Reviews radiographic images for clinically acceptable... ...and properly evaluates situations when physician intervention is necessary so that no...Flexible hoursShift work
WellStar Health System
Austell, GA1 day ago - ...Job Summary: Responsible for working collaboratively with physician partners to optimize quality and efficiency of care for hospitalized members by carrying out daily utilization and quality review, monitoring for inefficiencies and opportunities to improve care,...Full timeLocal areaImmediate start
Vivian Health
Decatur, GA4 days ago - ...45am - 3:15pm Emory Orthopedic and Spine Hospital utilizes 9 operating rooms with 12-23 cases per day. Coming this... ...levels. Identifies more complex patient needs by reviewing procedure protocol, physician's request, and assessing the patient's physical needs....Full timeShift work
Emory Healthcare
Atlanta, GA1 day ago - ...judgement, ingenuity and initiative in the utilization of equipment for the diagnosis and/or... ...appropriate right and left markers. Reviews CT/radiographic images for clinically acceptable... ...and evaluates situations requiring physician intervention. Verifies correct...ReliefImmediate startFlexible hoursShift work
WellStar Health System
Marietta, GA18 hours ago - ...more than 500 direct-care and support staff. Our staff of physicians, nurses, clinicians and support personnel is dedicated to helping... ...and levels of care. Performs clinical quality care reviews of medical staff and uses findings to improve performance and...Temporary workLocal area
DeKalb Community Service
Decatur, GA4 days ago - ...judgment, ingenuity and initiative in the utilization of equipment for the diagnosis and... ...have proper patient identification. Reviews images for clinically acceptable results... ...and properly evaluates situations when physician intervention is necessary so that no patient...Immediate startFlexible hoursShift work
WellStar Health System
Marietta, GA18 hours ago - ...workforce of over 500 direct-care and support staff. Our staff of physicians, nurses, clinicians, and support personnel are dedicated to... ...) interventions to de-escalate psychiatric emergencies. Utilize trauma-informed crisis intervention techniques to ensure safety...Full timeTemporary workReliefShift workNight shiftRotating shiftAfternoon shift
DeKalb Community Service
Decatur, GA4 days ago - ...and equipment needed for surgical procedure which includes review and utilization of appropriate preference card. * Assists with room set-up... ...reports any changes or significant findings to the physician and Registered Nurse. * Proactively plans for the next steps...Full timeImmediate startShift work
- ...0+ Subsidiaries What our current Physicians like about working at Talbott? Team... ...studies and follows-up on lab findings. Reviews all diagnostic and treatment/consult... ...and promptly performs internal utilization reviews as requested by Medical Director...Full timeLocal areaRelocation package
Universal Health Services
Atlanta, GA1 day ago - ...and equipment needed for surgical procedure which includes review and utilization of appropriate preference card. b) Assists with room set-up... ...immediately reports any changes or significant findings to the physician and Registered Nurse. p) Proactively plans for the next...Immediate startShift work
$221.14k - $315.92k
...great people to join our team. The Primary Care Physician (PCP) is a licensed/Board Certified/Board Eligible... ...role. Facilitates patient/family conferences to review treatment goals, optimize resource utilization, provide family education and identify needs. Enhances...Hourly payFull timeImmediate startChenMed
Decatur, GA3 days ago$133k - $154k
...care and services; collaborating with physicians, outside healthcare providers, and other... ...areas to ensure appropriate assignment and utilization; monitoring the use and maintenance of... ...feedback as needed on data collection, reviewing data, and translating reports into...Full timeTemporary workWork at officeLocal areaShift workKaiser Permanente
Atlanta, GA2 days ago- ...written or oral summary of preliminary findings to interpreting physician. Responsible for the safety and well-being of all... ...studies have proper patient identification and right/left marker utilization. Reviews ultrasound images for clinically acceptable results and...Immediate startFlexible hoursShift workWeekend work
- ...judgement, ingenuity and initiative in the utilization of the equipment for the diagnosis and/... ...marker are utilized appropriately. Reviews radiographic images for clinically acceptable... ...and properly evaluates situations when physician intervention is necessary so that no...ReliefFlexible hoursShift work
- ...Considerable contact with the staff from physicians offices, procedural area leadership and... ...leaders, provides weekly and daily clinical review of the surgical schedule to ensure... ...Millennium, Surginet and other systems utilized across procedural areas. MINIMUM QUALIFICATIONS...Shift work
Emory Healthcare
Atlanta, GA2 hours agonew
