Top 139 Clinical specialist Jobs in Lithonia, Ga

Utilization/Clinical Review RN -PRN
Children's Healthcare of Atlanta —Brookhaven, GA
- 8 hour shift
- Nursing
- RN License
- Computer literacy
Quick Apply
Clinical Application Specialist
United Digestive —Atlanta, GA
- Full-time
- Surgery
- Pass drug screening
- HIPAA
Quick Apply
Clinical Specialist | Urology - Urologic Cancer | Georgia
Boston Scientific —Atlanta, GA
- $85,000 - $120,000 a year
- Full-time
- Nursing
- Pass drug screening
- Mid-level
System Clinical Nurse Specialist, Oncology Services
Northside Hospital —Atlanta, GA
- Nursing
- Hospital
- Research
Clinical Nurse Specialist - Labor & Delivery
Northside Hospital —Atlanta, GA
- Nursing
- Hospital
- Mid-level
Licensed Clinical Psychologist - SHARE Military Initiative
Shepherd Center, Inc. —Atlanta, GA
- Full-time
- Doctoral degree
- 5 years
- BLS Certification
- Loan forgiveness
Quick Apply
Virtual Clinical Psychologist - Psy.D. or Ph.D.
PediaStaff —Atlanta, GA
- $75 - $115 an hour
- Choose your own hours
- Experience working with individuals with developmental disabilities
- Writing skills
- Doctor of Philosophy
- Health insurance
- 401(k)
Quick Apply
Clinical Development Specialist, Oncology/BMT Infusion Center
Northside Hospital —Atlanta, GA
- Nursing
- RN License
- PALS Certification
2d
Surg Tech-CVOR, WEO
Piedmont Healthcare —Atlanta, GA
- Full-time
- Surgery
- BLS Certification
- 3 years
Surg Tech - OR, Nights
Piedmont Healthcare —Conyers, GA
- Full-time
- Surgery
- BLS Certification
- 3 years
- Opportunities for advancement
Clinical Intake Specialist-LPN
The Columbus Organization —Georgia
- $22 - $24 an hour
- Full-time
- Nursing
- Mid-level
- Office
- Mileage reimbursement
- Health savings account
Quick Apply
Clinical Dietician- Oncology
Hunter International, Inc —Atlanta, GA
- $70,000 - $90,000 a year
- Master's degree
- Senior level
- Hospice & Palliative Medicine
Quick Apply
Med Surg Clinical Nurse Practice Specialist / RN
Emory Healthcare —Decatur, GA
- $57.62 - $66.79 an hour
- Full-time
- Nursing
- RN License
- PALS Certification
- Wellness program
- Health insurance
Clinical Documentation Specialist
Singing River Health System —Atlanta, GA
- Weekends as needed
- Remote
- Nursing
- Microsoft Outlook
- RN License
Quick Apply
Clinical Learning Specialist (RN)
Sprinter Health —Atlanta, GA
- Full-time
- Google Workspace
- Nursing
- RN License
- Paid holidays
- Disability insurance
Quick Apply
BMT Clinical Nurse Practice Specialist
Emory Healthcare —Atlanta, GA
- $57.62 - $66.79 an hour
- Full-time
- Nursing
- RN License
- PALS Certification
Clinical Specialist Pharmacist/ PRN
Emory Healthcare —Atlanta, GA
- $80 an hour
- Weekends as needed
- BLS Certification
- Mid-level
- Ability to lift 50 pounds
Clinical Informatics Specialist II
Emory Healthcare —Atlanta, GA
- $45.24 - $56.21 an hour
- Full-time
- Acute care
- Mid-level
- Master's degree
- Wellness program
- Health insurance
Clinical Development Specialist, Cardiac PCU
Northside Hospital Inc. —Lawrenceville, GA
- Full-time
- Nursing
- RN License
- PALS Certification
Clinical Specialist- Atlanta, GA- Neurovascular
Stryker —Atlanta, GA
- $130,000 a year
- Full-time
- Up to 50% travel
- Hospital
- Mid-level
- Health savings account
- AD&D insurance

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Utilization/Clinical Review RN -PRN

Children's Healthcare of Atlanta -
Brookhaven, GA

Quick Apply

Job Details

Part-time

Qualifications

Computer operation
RN License
Windows
Computer skills

Full Job Description

Note: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).

Work Shift

Variable

Work Day(s)

Variable

Shift Start Time

6:00 AM

Shift End Time

5:00 PM

Worker Sub-Type

PRN

Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.

Job Description

Participates as a member of a multidisciplinary team in completing pre-screening assessments of prospective patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary documentation and communication with internal and external customers.

This role is PRN and requires (6) 8-hour days per month with 1 day being on the weekend. We'll be open to offering more if possible. Some Holidays are required as well.

Training/Orientation will be 3 days/week (8-hour days) for 8-10 weeks. Onsite Orientation is needed 3-4 days for first week.

This role will be remote BUT regular meetings/trainings require being onsite at the Support Center in Atlanta GA.

Experience

3 years of experience in a healthcare setting; pediatrics preferred

Preferred Qualifications

Bachelor of Science in Nursing
Previous experience with MCG and/or InterQual systems
2 years of experience in hospital or insurance related utilization review highly preferred

Education

Graduation from an accredited school of nursing

Certification Summary

Licensure as a Registered Nurse in the single State of Georgia or Multi-State through the Enhanced Nurse Licensure Compact

Knowledge, Skills, and Abilities

Working knowledge of financial aspects of third-party payors and reimbursement
Effective decision-making/problem-solving skills
Demonstration of creativity in problem-solving
Must possess above-average computer skills
Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating within 30 days of employment

Job Responsibilities

Provides clinical information to insurance companies as needed for completion of pre-certification process as noted in Children's Healthcare of Atlanta utilization management plan.
Evaluates all patients, including critical care, for appropriateness of admission type and setting, utilizing a combination of clinical information, screening criteria, and third-party information within 24 hours or next business day.
Initiates and facilitates physician communications relative to utilization review process when indicated without prompting and follows up to ensure completion, including peer-to-peer reviews, securing admission orders, and reporting quality issues.
Reviews concurrently all inpatients, including critical care, every three days or sooner if payor requests, including information regarding patient's medical condition, intensity of services being utilized, treatment plan, and established review criteria.
Ensures all pertinent information is documented into various systems for utilization review process.
Gathers and reviews relevant medical information and documents utilization review process outcome based on system accepted utilization criteria on the accepted current review forms and in computer systems.
Supports organizational efforts to ensure accurate capture of admission status and level of care using Epic and escalating cases for status change where necessary.
Refers denied cases to appropriate personnel and provides assistance and/or clinical support to aid in appeal process.
Serves as resource to Case Management for facilitation of patients moving to appropriate level of care and notifying when patients no longer meet medical necessity to aid in discharge planning.
Meets productivity (10-12 reviews/day) and quality assurance (95%) standards and demonstrates utilization review proficiency with the successful completion and passing of McKesson Interrater Reliability testing.
Attends all required onsite, telephonic, and mandatory department meetings.
Participates in department activities to help promote utilization review process, aids in denial prevention, and serves as resource to peers and team members.

Children’s Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.

Primary Location Address

1575 Northeast Expy NE

Job Family

Nursing-Non Bedside

Quick Apply

Refine Your Search

clinical specialist jobs in lithonia, ga

Utilization/Clinical Review RN -PRN

Clinical Application Specialist

Clinical Specialist | Urology - Urologic Cancer | Georgia

System Clinical Nurse Specialist, Oncology Services

Clinical Nurse Specialist - Labor & Delivery

Licensed Clinical Psychologist - SHARE Military Initiative

Virtual Clinical Psychologist - Psy.D. or Ph.D.

Clinical Development Specialist, Oncology/BMT Infusion Center

Surg Tech-CVOR, WEO

Surg Tech - OR, Nights

Clinical Intake Specialist-LPN

Clinical Dietician- Oncology

Med Surg Clinical Nurse Practice Specialist / RN

Clinical Documentation Specialist

Clinical Learning Specialist (RN)

BMT Clinical Nurse Practice Specialist

Clinical Specialist Pharmacist/ PRN

Clinical Informatics Specialist II

Clinical Development Specialist, Cardiac PCU

Clinical Specialist- Atlanta, GA- Neurovascular

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