Average salary: $97,628 /yearly
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$26.41 - $61.79 per hour
...DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services... ...teams to promote the Molina care model. - Adheres to utilization management (UM) policies and procedures. Required Qualifications...SuggestedHourly payWork experience placementWork at officeMolina Healthcare
Decatur, GA51 minutes agonew- ...Utilization Management Manager Claratel Behavioral Health is seeking a dedicated and experienced Utilization Management Manager to oversee... ...the day-to-day functions of operations of utilization review including initial authorizations, concurrent reviews, reauthorizations...Suggested
DeKalb Community Service
Decatur, GA1 day ago - ...Blue Cypress is seeking a Utility Management Services (UMS) Director to oversee our company’s utility management consulting services... ...mitigate risk. Perform quality control and quality assurance reviews of deliverables in accordance with Blue Cypress policy, including...SuggestedWork at officeLocal areaRemote workWork from homeWork visa1 day per week
Blue Cypress Consulting, LLC
Decatur, GA1 day ago - ...Blue Cypress Consulting is seeking a Senior Utility Management Services (UMS) Consultant to support current projects and facilitate the... ...the project Perform quality control and quality assurance reviews of deliverables in accordance with Blue Cypress policy Maintain...SuggestedFor contractorsWork at officeLocal areaRemote workWork from homeWork visa1 day per week
Blue Cypress Consulting, LLC
Decatur, GA1 day ago - ...The Utility Management Consultant I, under guidance from a Senior Utility Management Consultant, will provide project management, strategic, and analytical support for Blue Cypress contracts. This person will be expected to support or conduct operational assessments, examine...SuggestedFor contractorsWork at officeLocal areaRemote workWork from homeWork visa1 day per week
Blue Cypress Consulting, LLC
Decatur, GA2 days ago - ...Blue Cypress is seeking a Utility Management Services (UMS) Regional Director to support current projects and oversee the staff of our... ...of the project Perform quality control and quality assurance reviews of deliverables in accordance with Blue Cypress policy,...SuggestedWork at officeLocal areaRemote workWork from homeWork visa1 day per week
Blue Cypress Consulting, LLC
Decatur, GA1 day ago $65k - $75k
...help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. The Utilization Review Specialist is responsible for performing utilization review services in compliance with URAC guidelines, applicable state...SuggestedTemporary work$70 - $72 per hour
Position Hospice Case Manager Base Pay Range $70.00/hr - $72.00/hr Seniority Level Mid-Senior level Employment Type Full-time Job Function Health Care Provider Qualifications Minimum 2 years experience as a hospice Case Manager BLS Certification required Benefits...SuggestedFull time- ...Atlanta location to perform precertification and medical necessity reviews on referrals, targeted outpatient procedures, and inpatient... ...state regulations. Ideal candidates will have experience in utilization management. The position supports a collaborative healthcare environment...Suggested
- ...5 Best Place to Work and Healthiest Employer", may be the place for you! Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management (PA/UM) team. The Review Nurse conducts prior approval and precertification reviews for Georgia...SuggestedContract work
Alliant Health Solutions, Inc.
Atlanta, GA3 days ago - A leading professional services firm is seeking a Utilization Review Specialist to perform utilization review services in compliance with regulations. The role involves conducting precertification and concurrent reviews while advocating for patients. Ideal candidates will...SuggestedRemote job
- A healthcare provider is seeking an experienced Utilization Review Coordinator for PRN weekend coverage. The role involves monitoring utilization of services, conducting reviews, and communicating with third-party payors. Candidates should possess a bachelor's degree or...SuggestedReliefWeekend work
- 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
- A healthcare organization is looking for a professional responsible for carrying out precertification and medical necessity reviews for referrals and inpatient admissions. Candidates should have strong communication skills and an understanding of medical review processes...Suggested
- ...Decatur, Georgia. This is a sensitive government position. Please review the GBI Employment Disqualifiers before applying for this... ...ordering supplies, invoice preparation, and processing payments utilizing the Agency's financial system. Investigative support duties...SuggestedWork at officeWork visa
$115k
...our website, please only use or . Additionally, our recruiters utilize email addresses with the @lifestance.com domain. Other... ...status should not be sent to this email address as they will not be reviewed or responded to. To apply for a position, please use our official...Full timeFlexible hoursLifeStance Health
Decatur, GA2 days ago- A healthcare staffing agency is seeking a travel nurse RN in Utilization Review for a position in Atlanta, Georgia. The role involves assessing and caring for patients, providing continued support, and developing care plans. Candidates should have at least one year of...
- A leading healthcare staffing agency is seeking a travel nurse RN for Utilization Review in Atlanta, Georgia. This role involves conducting utilization reviews, collaborating with healthcare professionals, and ensuring regulatory compliance. Ideal candidates will have...Weekly payContract work
$44.73k - $69.34k
...equipment, supplies, materials and services for the County; collects, reviews, and revises existing specifications; prepares solicitations... ..., negotiations, disputes and discrepancy resolutions; and utilizes standard County terms and conditions, terminology, documentation...Full timeContract workLocal area$2,640 per week
Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. Job Details Specialty: Utilization Review Discipline: RN Start Date: 03/22/2026 Duration: 12 weeks 40 hours per week Shift: 8 hours, days Employment...Private practiceShift work$2,500 per week
Job Description & Requirements LanceSoft is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. Details Specialty: Utilization Review Discipline: RN Start Date: 03/16/2026 Duration: 13 weeks Hours per week: 40 Shift: 8 hours...Weekly payLong term contractPermanent employmentTemporary workWork at officeShift work- ...Truist Mortgage policies and procedures as well as loan guidelines utilized by the Bank. # Adhere to and comply fully with any and all... ...and solution of client complaints. # Conduct loan pipeline reviews to ensure client's speed-to-decision/close, contractual deadlines...Work at office
$17.68 - $29.62 per hour
...upkeep, installation, and construction of County grounds, property, utilities, rights-of-way, and other infrastructure for departmental... ..., maps, manuals, reference materials, and other documents; and reviews, completes, processes, forwards or retains as appropriate. Communicates...Immediate start- ...negotiation skills. **Key Responsibilities:** Processes payments for utilities and other fees and services; receives monies from customers by... ...related documentation and reports. Monitors past due accounts; reviews delinquent customer listing; contacts customers to investigate...Work at office
- ...billing, accounting, or finance and a proactive approach to problem-solving.Key Responsibilities: Prepares and processes utility service bills; reviews billing charges and meter readings; prepares and submits billing and usage reports; prepares bills for mailing; and...Work at office
$10k
...interested in these federal law enforcement opportunities and review the qualifications section below to see if you are qualified.... ...primary duties in an official law enforcement capacity such as: Utilizing intelligence information to track illegal operations, criminal...Full timeLocal areaImmediate startRelocationNight shift- .... ESSENTIAL FUNCTIONS OF THE JOB. JOB FUNCTION Pre-preparation Review menus prior to preparation of food. Process diet changes and new... .../Manager. Post-preparation Follows posted cleaning schedules utilizing proper sanitation and cleaning methods. Cleans food preparation...Full timeWork experience placementLocal area
- Hmong Chinese Language Document Reviewer Employment Type: Full Time, Mid-Level Department: Legal As a CGS Hmong Chinese Document Reviewer... ...; Produces a variety of written documents and materials utilizing a wide range of office software applications; Establishes and...Full timeWork at officeFlexible hours
- ...Responsible for carrying out precertification and medical necessity reviews on all designated referrals as well as targeted outpatient... ...procedures, services and inpatient admissions, as well as referrals, utilizing established criteria and guidelines, retrospective ED reviews....Permanent employmentContract work
- ...property condition assessments and construction consulting services. We have a unique opportunity in our Frisco office for a technical reviewer and are looking for qualified professionals that have a strong desire to help maintain our high standards. This full‑time...Full timeFlexible hours
