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VNHS is committed to sustaining our investment in robust community partnerships, delivering coordinated care solutions, cultivating a top-performing workforce, and advancing innovative technologies to enhance affordability and patient care accessibility. Caring for Atlanta for over 77 years, Visiting Nurse Health System is a leading, non-profit provider of home healthcare, long-term care at home, hospice, and palliative care services.

YEAR

Visiting Nurse Health System Inc

Registered Nurse Case Manager (RN) - Home Health

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Minimum Required Qualifications: Education and Experience: - Graduate of an accredited prelicensure Bachelor of Science in Nursing (BSN), AND 3 years of recent nursing experience in critical care and ability to manage patients in all specialties of Emory Critical Care; OR - Graduate of an accredited prelicensure Associate Degree in Nursing (ADN) with a minimum of 3 years of recent nursing experience in critical care and ability to manage patients in all specialties of Emory Critical Care. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste; Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor surfaces; Hot/cold temperatures; Indoor/outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators.

Emory Healthcare Inc

Rapid Response RN

PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required.

Operating Room Coordinator RN / Procedural Service Line

While completing job functions, the Case Manager works closely with attending physicians, physician offices, business office personnel, nursing personnel, medical records personnel, third-party reimbursement representatives, some government agencies, all ancillary departments furnishing care or services to patients, families, or caregiver, the general public and all community resource agencies. While completing job functions works closely with attending physicians, physician offices, business office personnel, nursing personnel, medical records personnel, third-party reimbursement representatives, some government agencies, all ancillary departments furnishing care or services to patients, families, or caregiver, the general public and all community resource agencies.

Southwell Inc

Case Manager (RN)

Essential Functions: Engage the member and their natural support system through strength-based assessments and a trauma-informed care approach using motivation interviewing to complete health and psychosocial assessments through a health equity lens unique to the needs of each member that identify the cultural, linguistic, social and environmental factors/determinants that shape health and improve health disparities and access to public and community health frameworks. Job Summary: The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the population through culturally competent delivery of care and coordination of services and supports.

CareSource

Community Based Care Manager RN

Francis has been recognized and awarded multiple high-performing honors by U.S. News & World Report, and received multiple disease-specific certifications from the Joint Commission, and was a rated Top Large Hospital in Georgia. This role ensures effective case management processes that promote optimal patient outcomes, quality of care, regulatory compliance, and cost efficiency across the continuum of care.

Knight Health Holdings LLC

Case Manager - RN

In this role you will be supporting the FCR team in addition to a small clinical coder team of 2 clinical coders who will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as EDC (Emergency Department Coding), MS-DRG and APR-DRG reviews based on clinical determination. Acts as a resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial activity and works with teams to create transparency and improvements to mitigate and prevent denials.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Clinical Coding Analyst RN, Consultant

The Work and Campus Care Solutions team is headquartered in Macon, Georgia, and provides services throughout the Central Georgia market, including locations in Macon, Milledgeville, Fort Valley, Barnesville, Morrow, Warner Robins, and surrounding areas. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise.

HOUR

Advocate Health and Hospitals Corporation

Supervisor Registered Nurse- Work and Campus Care Solutions

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The Clinical Appeals Nurse will be responsible for appropriately tracking the status of Appeals in-process within the Epic system, report on Appeals success rates by payor and assist in identifying trends that lead to initial clinical denials. The Clinical Appeals Nurse evaluates the appropriateness of payor clinical denials and level of care status downgrades by working with stakeholders throughout the health system to compose informed, effective appeals to overturn denials.

Grady Health System

Clinical Appeals Nurse

Maintains effective interaction/communication with members of the medical staff, health care teams, intake coordinators, complex case managers, social workers, inpatient care coordinators, referral coordinators, Member Services, Claims, Contracts and Benefits-Appeals, Risk Management and Kaiser Permanente medical offices to facilitate the review process. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.

At Kaiser Permanente, we are relentless in our pursuit of excellence. Driven by our mission to provide the highest quality preventive medicine, we are committed to eliminating health care disparities, and to making lives better through innovation, technology, and research.

Our desire to deliver the best possible care inspires us to promote wellness among our members, communities, and each other. It also fuels our belief that everyone — regardless of circumstance — deserves access to affordable care, which further drives our motivation to expand our reach.

Founded nearly 80 years ago, our unique business model sets us apart — positioning us to drive improvements across the industry and around the world.

Kaiser Permanente

RN, Specialty Care Review On Call PRN

IRecruitee

FULL_TIME

The ideal candidate will have a deep understanding of surgery center workflows, facility management, and patient experience strategies, with the ability to deploy scalable systems across multiple locations. Company Overview: EyeSouth Partners is a leading physician-founded eye care organization building a premier network of clinical excellence across the nation.

EyeSouth Partners

RN Regional Operations Manager, Surgical Services

[AW]-iCims

Evidence-based Practice, Nursing Research, Quality of Practice, Patient Satisfaction Scores, External Reporting/Benchmarks The Northside Hospital Staff Registered Professional Nurse manages patient care of an assigned group of patients in accordance with the philosophy and policies of Northside Hospital. Responsibilities: The Registered Professional Nurse at Northside Hospital independently plans and provides professional nursing care to patients in accordance with physician orders and established guidelines, and in accordance with the scope of practice as defined by the Georgia Nurse Practice Act.

Northside Hospital Inc.

Staff RN Super User- Acute Medicine Unit

Staff RN Super User- Acute Neuro Unit

Staff RN III-CS

Staff RN Super User- Acute Surgery

Staff RN Super User- Acute GI

Accurately documents all patient observations, treatments, and procedures administered, patient/family responses, medication dispensed or prescribed, hospital data in the medical record. Administers immunizations and injections after reviewing immunization records, potential allergic reactions, identifies and reviews side effects and treatments.

Sullivan Group HR

Triage Nurse {OBGYN)

Talent Acquisition

The Clinical Support LPN also supports the Clinical Services Department through activities involving staff education, site accreditation, program & site continuous quality improvement, site transition, and other areas within the Clinical Services Department as needed. Currently, CorrectHealth provides high quality, cost-effective, comprehensive healthcare services inside the walls of more than 40 correctional facilities throughout Georgia and Louisiana.

CorrectHealth Career

Licensed Practical Nurse (LPN)-Clinical Services

Responsible for managing the clinical operations of Hospice Services to include general supervision and responsibility for the planning, organizing, coordination and evaluation of all day-to-day aspects of Hospice patient care. Assures effective coordination between Hospice clinical staff and clerical staff so that paperwork necessary for payroll and billing is submitted accurately and according to established time frames.

Georgia Med Group

RN Clinical Services Supervisor Hospice Services

This role supervises nursing staff, coordinates care with healthcare teams, and maintains compliance with healthcare regulations and hospital policies while fostering a positive work environment and promoting professional development. Join our team at East Georgia Regional Medical Center as a Registered Nurse and take advantage of our outstanding benefits, including UP TO $20,000 Sign-On Bonus and up to $20,000 in Student Loan Contributions.

<p>Community Health Systems, Inc. is a non-profit 501 (c) (3) 330 HRSA Grantee with Federally Qualified Health Center (FQHC) status. Established from the roots of Inland Empire Community Health Center in Bloomington, CHSI has grown with community health centers in the counties of Riverside, San Bernardino, and San Diego. These centers have been developed in accordance with standards established for safety net providers by the U.S. Department of Health and Human Services (HHS), the Health Resources Services Administration (HRSA), the Public Health Service (PHS), and the Bureau of Primary Health Care (BPHC). <br><br>As such, services are offered to the neediest in each community - the un-insured and under-insured, the working poor, those with limited ability to pay, the homeless, and the indigent. Services are provided at discounted (sliding fee scale) rates for those who qualify based on gross annual income and family size. </p>

Utilization Management Nurse Jobs in Georgia

Registered Nurse Case Manager (RN) - Home Health Visiting Nurse Health System Inc

Rapid Response RN Emory Healthcare Inc

Operating Room Coordinator RN / Procedural Service Line Emory Healthcare Inc

Case Manager (RN) Southwell Inc

Community Based Care Manager RN CareSource

Case Manager - RN Knight Health Holdings LLC

Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield Association

Supervisor Registered Nurse- Work and Campus Care Solutions Advocate Health and Hospitals Corporation

Clinical Appeals Nurse Grady Health System

RN, Specialty Care Review On Call PRN Kaiser Permanente

RN Regional Operations Manager, Surgical Services EyeSouth Partners

Staff RN Super User- Acute Medicine Unit Northside Hospital Inc.

Staff RN Super User- Acute Neuro Unit Northside Hospital Inc.

Staff RN III-CS Northside Hospital Inc.

Staff RN Super User- Acute Surgery Northside Hospital Inc.

Staff RN Super User- Acute GI Northside Hospital Inc.

Triage Nurse {OBGYN) Sullivan Group HR

Licensed Practical Nurse (LPN)-Clinical Services CorrectHealth Career

RN Clinical Services Supervisor Hospice Services Georgia Med Group

RN Clinical Coordinator ER Community Health Systems Inc

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