Top 294 Utilization management nurse Jobs in Georgia

MDS Coordinator
Autumn Breeze Organization, LLC —Marietta, GA
- $37 - $45 an hour
- Full-time
- Nursing
- Anatomy knowledge
- Skilled nursing facility
- Health insurance
- Dental insurance
Quick Apply
6d
Utilization Management Nurse (contract)
Elevance Health —Atlanta, GA
- Contract
- Hybrid work
- 6 years
- LVN
- RN License
- Health savings account
- Disability insurance
6d
Utilization Management Nurse
Health One Alliance, LLC —Dalton, GA
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Wellness program
- Health savings account
Utilization Management Behavioral Health Professional
Humana —Georgia
- $65,000 - $88,600 a year
- Weekends as needed
- Remote
- LMFT
- Microsoft Excel
- RN License
- Paid parental leave
- Paid holidays
22h
Med Mgmt Nurse (contract)
Elevance Health —Decatur, GA
- $35.95 - $51.49 an hour
- Contract
- Hybrid work
- Nursing
- RN License
- Mid-level
- Health savings account
- Disability insurance
Utilization Management Nurse Team Lead
Health One Alliance, LLC —Dalton, GA
- Full-time
- Background check
- Nursing
- Microsoft Excel
- Wellness program
- Health savings account
Psychiatric Nurse Practitioner
SouthlandMD —Saint Simons Island, GA
- $160,000 - $183,000 a year
- Full-time
- Nursing
- Psychiatry
- Addiction Medicine
Quick Apply
Psychiatric Nurse Practitioner
SouthlandMD —Saint Simons Island, GA
- $400 - $680 a day
- PRN
- Nursing
- Psychiatry
- Addiction Medicine
Quick Apply
Assistant Nurse Manager - Inpatient Aflac Hematology / Oncology & Bone Marrow Transplant Unit at Arthur M. Blank Hospital
Children's Healthcare of Atlanta —Atlanta, GA
- Full-time
- Nursing
- RN License
- Bachelor of Science
Quick Apply
Medical Field Case Manager
Enlyte —Augusta, GA
- $80,000 - $90,000 a year
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Mileage reimbursement
RN Diagnostic Imaging
Fairview Park Hospital —Dublin, GA
- Full-time
- Mid-level
- Critical & Intensive Care
- Neurology
- Employee stock purchase plan
- Disability insurance
Quick Apply
Endo Manager, RN
United Digestive —Covington, GA
- Full-time
- Nursing
- RN License
- BLS Certification
Quick Apply
Registered Nurse-Supervisor of Clinical Home Care Services
Trinity Health At Home —Watkinsville, GA
- Online Application
- CPR Certification
- Nursing
- Microsoft Outlook
- Mileage reimbursement
- Disability insurance
Quick Apply
Endo Manager, RN
United Digestive —Conyers, GA
- Full-time
- Nursing
- RN License
- BLS Certification
Quick Apply
Endo Manager, RN
United Digestive —Lawrenceville, GA
- Full-time
- Nursing
- RN License
- BLS Certification
Quick Apply
Medical Field Case Manager
Enlyte —Marietta, GA
- $80,000 - $83,000 a year
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Mileage reimbursement
Manager of Case Management (RN or LCSW)
All Med Search —Savannah, GA
- $45 - $50 an hour
- Full-time
- Nursing
- RN License
- Hospital
- Relocation assistance
- Health insurance
Quick Apply
MDS Coordinator/ RN/LPN
Buchanan Healthcare Center —Buchanan, GA
- Full-time
- Anatomy knowledge
- RN License
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Travel RN-House Supervisor-Days/Nights-36 Hours-Duluth, GA-$3,185.00
Prolink —Duluth, GA
- $3,185 a week
- Night shift
- Background check
- Experience working with individuals with developmental disabilities
- Nursing
- Health insurance
- Dental insurance
Quick Apply
13h
Dialysis Clinical Manager Registered Nurse - RN
Fresenius Medical Care —Atlanta, GA
- Full-time
- Nursing
- Heavy lifting
- RN License
- Tuition reimbursement
Quick Apply

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MDS Coordinator

Autumn Breeze Organization, LLC
Marietta, GA

Quick Apply

Job Details

Full-time
$37 - $45 an hour
6 days ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance
Life insurance

Qualifications

Anatomy knowledge
Skilled nursing facility experience
Long-term care regulations
Medicare
Utilization review
HIPAA
Care documentation
Long-term care facility experience
Health insurance knowledge
Medicare regulations
Electronic health record (EHR) management for billing and coding
Utilization management
Attention to detail
Centers for Medicare and Medicaid Services (CMS)
Resource utilization in healthcare
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Clinical documentation improvement
Health information management
Medical data abstraction
Clinical confidentiality policies
Clinical documentation standards
Managing patient records
Medical terminology
Medical record review for billing accuracy

Full Job Description

Job Summary
We are seeking a dedicated and detail-oriented MDS (Minimum Data Set) Coordinator to join our healthcare team. In this vital role, you will oversee the comprehensive assessment and documentation process for residents in long-term care facilities, ensuring compliance with federal and state regulations. Your expertise will support clinical decision-making, optimize patient care, and facilitate accurate reimbursement through meticulous data management. The ideal candidate will possess strong knowledge of clinical documentation, medical coding, and healthcare information systems, driving quality improvement and regulatory adherence.

Duties

Lead the completion and review of MDS assessments to accurately reflect residents’ clinical status, ensuring compliance with CMS (Centers for Medicare & Medicaid Services) standards.
Collaborate with interdisciplinary teams including nursing, therapy, social work, and physicians to gather comprehensive resident information.
Utilize EMR (Electronic Medical Record) systems such as Epic, to document assessments and update patient records efficiently.
Conduct thorough documentation reviews to ensure accuracy in medical records, coding (ICD-10, CPT), and clinical data for reimbursement purposes.
Coordinate with utilization review and management teams to support appropriate level-of-care determinations and discharge planning.
Maintain up-to-date knowledge of regulatory requirements including NCQA standards, Medicare guidelines, and HIPAA compliance.
Provide education and training to staff on documentation best practices, coding updates, and regulatory changes related to MDS processes.

Requirements

Proven experience with MDS coordination in a long-term care or skilled nursing facility setting.

Registered Nurse Preferred
Strong understanding of medical terminology, anatomy, physiology, and clinical documentation improvement strategies.
Proficiency in EMR/EHR systems such as Epic, PCC
Knowledge of ICD-10/ICD coding, CPT coding, DRGs (Diagnosis-Related Groups), and Medicare regulations.
Experience with utilization review/management processes within .
Background in nursing or healthcare administration with relevant certifications is highly desirable.
Familiarity with managed care protocols and home care or hospice environments is advantageous.
Ability to interpret complex medical records and ensure compliance with HIPAA standards while managing sensitive health information. Join our team as an MDS Coordinator to make a meaningful impact on patient care quality while advancing your career in a dynamic healthcare environment!

Pay: $37.00 - $45.00 per hour

Benefits:

Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

utilization management nurse jobs in georgia

MDS Coordinator

Utilization Management Nurse (contract)

Utilization Management Nurse

Utilization Management Behavioral Health Professional

Med Mgmt Nurse (contract)

Utilization Management Nurse Team Lead

Psychiatric Nurse Practitioner

Psychiatric Nurse Practitioner

Assistant Nurse Manager - Inpatient Aflac Hematology / Oncology & Bone Marrow Transplant Unit at Arthur M. Blank Hospital

Medical Field Case Manager

RN Diagnostic Imaging

Endo Manager, RN

Registered Nurse-Supervisor of Clinical Home Care Services

Endo Manager, RN

Endo Manager, RN

Medical Field Case Manager

Manager of Case Management (RN or LCSW)

MDS Coordinator/ RN/LPN

Travel RN-House Supervisor-Days/Nights-36 Hours-Duluth, GA-$3,185.00

Dialysis Clinical Manager Registered Nurse - RN

I want to receive the latest job alert for utilization management nurse in georgia

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