Top 343 Utilization management Jobs in Austell, Ga

Inpatient Care Management Nurse - Remote
Optum —Atlanta, GA
- $60,200 - $107,400 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health insurance
Quick Apply
2d
Case Management Authorization. Specialist IP
Emory Healthcare —Decatur, GA
- $24.12 - $29.39 an hour
- Part-time
- Mid-level
- High school diploma or GED
- Ability to lift 50 pounds
- Wellness program
- Health insurance
4d
Case Management Authorization. Spec IP
Emory Healthcare —Atlanta, GA
- $24.12 - $29.39 an hour
- Part-time
- Mid-level
- High school diploma or GED
- Ability to lift 50 pounds
- Wellness program
- Health insurance
Manager of Clinical Annotation - Remote
UnitedHealthcare —Atlanta, GA
- $91,700 - $163,700 a year
- Full-time
- Remote
- Nursing
- RN License
- 5 years
Clinical Audit/Denials Specialist, RN
Northside Hospital Inc. —Atlanta, GA
- Full-time
- Remote
- Nursing
- Hospital
- Mid-level
Utilization Review Specialist
Positive Impact Health Centers INC —Decatur, GA
- Full-time
- LMFT
- Psychiatry
- RN License
4d
Med Mgmt Clinician Sr (contract)
Elevance Health —Atlanta, GA
- Contract
- Hybrid work
- 6 years
- LVN
- RN License
- Health savings account
- Disability insurance
GA - Intake Nurse
Abby Care —Atlanta, GA
- $75,000 - $85,000 a year
- Full-time
- Bilingual
- RN License
- Mid-level
- Commuter assistance
- Paid parental leave
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
Medication Access Coordinator
Grady Health System —Atlanta, GA
- Full-time
- Microsoft Excel
- Writing skills
- Research
- Paid holidays
- Disability insurance
RN Case Manager -Remote
Optum —Atlanta, GA
- $60,200 - $107,400 a year
- Full-time
- Remote
- Nursing
- RN License
- Pass drug screening
Quick Apply
2d
Supervisor, Health Information Management
Emory Healthcare —Atlanta, GA
- $32.34 - $39.40 an hour
- Full-time
- Office
- High school diploma or GED
- Bachelor's degree
- Wellness program
- Health insurance
Utilization Specialist
RiverWoods Behavioral Health —Riverdale, GA
- Part-time
- CPR Certification
- Nursing
- RN License
Sr. Quality of Care Review Nurse
Oscar Health —Atlanta, GA
- $83,628.00 - $109,761.75 a year
- Remote
- Spanish
- Nursing
- RN License
- Paid parental leave
- Paid holidays
Quick Apply
5d
Bed Control Specialist FT Nights
3110 Kennestone Hospital, Inc. —Marietta, GA
- Full-time
- Hospital
- Word processing
- Computer literacy
Dedicated Care Navigator (EAP Onsite)
Spring Health —Austell, GA
- $38.46 - $48.71 an hour
- Full-time
- Bilingual
- LMFT
- Hospital
- Health savings account
- Health insurance
Quick Apply
Prior Authorization Pharmacist
Curant Health —Smyrna, GA
- $125,000 a year
- Full-time
- Hybrid work
- Mid-level
- Team management
- 2 years
- Paid parental leave
- Paid holidays
Quick Apply
5d
Dementia Care Navigator - Cognitive Care (Days)
Tanner Health System —Villa Rica, GA
- Full-time
- Nursing
- Mid-level
- Bachelor's degree
Mgr 3, Hlth Care
Georgia Department of Public Health —Atlanta, GA
- $81,955.29 a year
- Full-time
- Nursing
- Master's degree
- Bachelor's degree
12d
Healthguide - Community Resource
Guidehealth —Atlanta, GA
- $19.00 - $20.50 an hour
- Full-time
- Remote
- Bilingual
- HIPAA
- Mid-level
- Paid parental leave
- Disability insurance

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utilization management jobs near austell, ga

Inpatient Care Management Nurse - Remote

Optum -
Atlanta, GA

Quick Apply

Job Details

Full-time
$60,200 - $107,400 a year
2 days ago

Benefits

Health insurance

Qualifications

Nursing
Microsoft Excel
Microsoft Outlook
Inpatient experience
Utilization review
RN License
Windows
Acute care facility experience
Utilization management
Resource utilization in healthcare
Nursing

Full Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization.

What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

Schedule will vary to include some weekend requirements based off the business needs.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (InterQual criteria)
Discuss cases with facility healthcare professionals to obtain plans-of-care
Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management
Participation in discussions with the Clinical Services team to improve the progression of care to the most appropriate level
Consult with the Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners
Apply clinical expertise when discussing case with internal and external Case Managers and Physicians
Identify delays in care or services and manage with MD
Follow all Standard Operating Procedures in end-to-end management of cases
Obtain clinical information to assess and expedite alternate levels of care
Facilitate timely and appropriate care and effective discharge planning
Participate in team meetings, education, discussions, and related activities
Maintain compliance with Federal, State and accreditation organizations
Identify opportunities for improved communication or processes
Participate in audit activities and meetings

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Active, unrestricted RN license in state of residence
1+ years of clinical nursing experience in a Hospital setting
1+ years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or within a health insurance company
Proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms
Designated workspace and access to install secure high-speed internet via cable / DSL in home

Preferred Qualifications:

Bachelor's degree
Compact RN license
2+ years of acute inpatient case management experience/utilization review
Managed care experience
Experience performing discharge planning

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Quick Apply

Refine Your Search

utilization management jobs in austell, ga

Inpatient Care Management Nurse - Remote

Case Management Authorization. Specialist IP

Case Management Authorization. Spec IP

Manager of Clinical Annotation - Remote

Clinical Audit/Denials Specialist, RN

Utilization Review Specialist

Med Mgmt Clinician Sr (contract)

GA - Intake Nurse

Med Mgmt Nurse (contract)

Medication Access Coordinator

RN Case Manager -Remote

Supervisor, Health Information Management

Utilization Specialist

Sr. Quality of Care Review Nurse

Bed Control Specialist FT Nights

Dedicated Care Navigator (EAP Onsite)

Prior Authorization Pharmacist

Dementia Care Navigator - Cognitive Care (Days)

Mgr 3, Hlth Care

Healthguide - Community Resource

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