RN Case Manager: Utilization Review & Care Coordination

Healthcare Support Staffing; Atlanta (GA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive salary

Medical, Dental, and Vision benefits

Fun and positive work environment

Job summary

A leading healthcare staffing agency in Atlanta is seeking a qualified Registered Nurse to join their team. This role involves reviewing patient admissions, providing clinical resources, and entering data into the system. The position offers a competitive salary and benefits including medical, dental, and vision. The work environment is described as fun and positive, with hours from Monday to Friday, 8:30 AM to 5:00 PM.

Qualifications

• Prior Authorization experience from another managed care company or hospital.
• Experience with Interqual or Milliman is strongly preferred.
• Insurance experience (Medicare, Medicaid, commercial).

Responsibilities

• Review admissions to ensure medical necessity and appropriate level of care.
• Act as clinical resources to referral staff and make appropriate referrals.
• Data enters assessments, authorizations and reviews into the system.

Skills

Prior Authorization experience

Experience with Interqual or Milliman

Insurance experience (Medicare, Medicaid, commercial)

Job description

A leading healthcare staffing agency in Atlanta is seeking a qualified Registered Nurse to join their team. This role involves reviewing patient admissions, providing clinical resources, and entering data into the system. The position offers a competitive salary and benefits including medical, dental, and vision. The work environment is described as fun and positive, with hours from Monday to Friday, 8:30 AM to 5:00 PM.