EmploymentCrossing Jobs

Commercial Medical Director - Work At Home - USA-GA-Atlanta

Mon, 26 Jun 2023 00:00:00 CDT

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of...

RN Care/Case Manager- CenterWell - Atlanta, GA - USA-GA-Atlanta

Mon, 26 Jun 2023 00:00:00 CDT

Description CenterWell Senior Primary Care, a subsidiary of ******* , is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana...

Medical Director - Florida Medicaid - USA-GA-Atlanta

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Medical Director - Florida Medicaid in Atlanta Georgia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignm...

RN Case Manager - Telephonic Nurse 2 - Complex Case Management Program (Remote) - USA-GA-Atlanta

Fri, 07 Apr 2023 00:00:00 CDT

Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding mem...

Behavioral Health Medical Director - USA-GA-Atlanta

Fri, 23 Dec 2022 00:00:00 CST

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive cl...

Medical Director-KY Medicaid - USA-GA-Atlanta

Sun, 25 Dec 2022 00:00:00 CST

Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Directo...

Grievances and Appeals Medical Director - Nationwide - USA-GA-Atlanta

Fri, 14 Apr 2023 00:00:00 CDT

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interp...

Medical Director - Claims Management - USA-GA-Atlanta

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-GA-Atlanta

Thu, 20 Apr 2023 00:00:00 CDT

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situa...

Grievances and Appeals Medical Director - Weekends Required - USA-GA-Atlanta

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - South Central - USA-GA-Atlanta

Thu, 20 Apr 2023 00:00:00 CDT

Behavioral Health Medical Director - Tricare - USA-GA-Atlanta

Thu, 04 May 2023 00:00:00 CDT

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately comple...

Senior Pre-Authorization Nurse - USA-GA-Atlanta

Mon, 11 Sep 2023 00:00:00 CDT

Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to t...

Registered Nurse Clinical Nurse Labor & Delivery III N - USA-GA-Marietta

Fri, 23 Jun 2023 00:00:00 CDT

Overview\nWellStar Kennestone Hospital has an opportunity for a Labor & Delivery Registered Nurse .\n \nFull-Time Day Shift 7:00am -7:00pm \n \nAs one of the Top 100 hospitals, WellStar Kennestone of...

Pre-Authorization Nursing Supervisor - USA-GA-Atlanta

Sat, 13 May 2023 00:00:00 CDT

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward reques...

RN Clinical Coordinator-PerOp-General Surgery - USA-GA-Austell

Sat, 20 May 2023 00:00:00 CDT

Overview\nMake a difference in patients\u2019 lives\u2026 and your own!\nMonday-Friday 6:45AM-3:30PM\n \nHow would you like to work in a place where your contributions and ideas are valued? A place wh...

Co Responder Licensed Clinician - USA-GA-Atlanta

Tue, 30 May 2023 00:00:00 CDT

Co-Responder Licensed Clinician We are looking to fill the position of Co-responder Licensed Clinician. The Co-responder Clinician will work in close partnership with EMTs, responding to calls invol...

Clinical Case Manager - USA-GA-Atlanta

Tue, 30 May 2023 00:00:00 CDT

At ******* our goal is to create a high-performing culture comprised of energized employees who teach, learn and play as a team to win. If you think you are the perfect fit for this job, wed love ...

Nurse Manager - USA-GA-Decatur

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n Applicants pending the completion of educational or certification/licensure requirements ...

Home Health Registered Nurse - USA-GA-Atlanta

Tue, 13 Jun 2023 00:00:00 CDT

Job Information Humana Home Health Registered Nurse in Atlanta Georgia Description Responsibilities As a Home Health Registered Nurse , you will: Provide admission, case management, and follow-up sk...