Atlanta, Georgia, United States · Remote Solely
$47/hr–$54/hr
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of …
Skills: Medical Necessity Review, InterQual Criteria, Patient Class Designation, Clinical Nursing Judgement, Utilization Management
Atlanta, Georgia, United States · On-site
$17/hr
Our Mission and Vision: The mission of United Cerebral Palsy of Georgia is to positively support and impact the achievement of a Life Without Limits for people with intellectual and developmental disabilities. UCP of Geo…
Skills: Verbal Communication, Written Communication, Interpersonal Skills, Customer Service, Organizational Skills
Atlanta, Georgia, United States · On-site
$26/hr–$41/hr
Up to $8,000 Sign-On Bonus Offered, based on experience!!! Licensed Practical Nurse LPN Emory Dialysis at Northside - Atlanta, GA Health Systems Management, Inc. (HSM) is a full-service healthcare management organization…
Skills: Dialysis Treatment, Nursing Process, Patient Care, Bedside Manner, Communication Skills
Atlanta, Georgia, United States · On-site
$17/hr
Our Mission and Vision: The mission of United Cerebral Palsy of Georgia is to positively support and impact the achievement of a Life Without Limits for people with intellectual and developmental disabilities. UCP of Geo…
Skills: Verbal Communication, Written Communication, Interpersonal Skills, Customer Service, Organizational Skills
Atlanta, Georgia, United States · On-site
Discover Your Career at Emory University Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidat…
Skills: Anesthesiology, POCUS, Regional Anesthesia, Cardiac Anesthesia, Clinical Care
Atlanta, Georgia, United States · On-site
$55/hr–$65/hr
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of …
Skills: Clinical Nutrition Management, Budget Management, Staff Supervision, Dietetic Internship Direction, ACEND Standards Compliance
Atlanta, Georgia, United States · On-site
Overview Come join a company that strives for Extraordinary People and Exceptional Performance! Chenega Enterprise Systems & Solutions, LLC, a Chenega Professional Services’ company, is seeking to hire an experienced Hea…
Skills: Project Management, Health Communication, Data Visualization, Writing And Editing, Marketing Programs
Atlanta, Georgia, United States · On-site
$17/hr–$26/hr
Phlebotomist II - Atlanta, GA, Monday to Friday, 8:00 AM to 5:00 PM Pay range: $21.17+ per hour Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where ap…
Skills: Phlebotomy, Pediatric Collection, Geriatric Collection, Capillary Collection, Data Entry
Atlanta, Georgia, United States · On-site
Responsibilities Business Development/Marketing & Sales Rep Behavioral Health Hospital Based Peachford Hospital, the gold standard for behavioral health treatment in Atlanta, is searching for an experienced Business Deve…
Skills: Business Development, Outside Sales, Behavioral Health Knowledge, Public Speaking, Time Management
Atlanta, Georgia, United States · On-site
$47/hr–$54/hr
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of …
Skills: Clinical Leadership, Staff Supervision, Conflict Resolution, Patient-Centered Care, Resource Management
Atlanta, Georgia, United States · On-site
Overview Assists the Applications Coordinator or Manager in the coordination of activities and resources for all hospital financial or clinical applications. Responsibilities Maintain a thorough working knowledge of all …
Skills: Cerner Ambulatory, Project Management, System Implementation, Clinical Application Support, Analytical Skills
Atlanta, Georgia, United States · On-site
$43/hr–$49/hr
Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of …
Skills: Patient Assessment, Nursing Process, Care Plan Development, Electronic Health Records, Patient Advocacy
Atlanta, Georgia, United States · On-site
Responsibilities Laurel Heights Hospital located in Atlanta Georgia has a full-time MARKETING REPRESENTATIVE FOR BUSINESS DEVELOPMENT. Laurel Heights Hospital is an intensive Residential Treatment/Acute and Autism Spectr…
Skills: Business Development, Marketing, Contracting, Admissions, Written Communication
Atlanta, Georgia, United States · On-site
Summary The Accounting Manager serves as a subject matter expert and technical accounting lead within the accounting department. This role does not carry direct supervisory responsibility but provides oversight review of…
Skills: General Ledger, Financial Reporting, Month-end Close, US GAAP, Cash Flow Management
Atlanta, Georgia, United States · On-site
Job Summary: The Biomedical Technician is responsible for providing preventative maintenance and repair services on clinical and diagnostic medical equipment and instrumentation used in the medical centers throughout the…
Skills: Preventative Maintenance, Medical Equipment Repair, Electrical Safety Testing, Calibration, Inventory Management
Atlanta, Georgia, United States · On-site
Overview The Clinical Supervisor is a member of the unit-based leadership team. Provides supervision of the nursing operations of a unit. In the absence of the Manager or Director may assume 24-hour nursing responsibilit…
Skills: Nursing Supervision, Patient Acuity Assessment, Staff Scheduling, Clinical Training, Quality Improvement
Atlanta, Georgia, United States · On-site
Company Description CRB's over 1,100 expert professionals drive innovative, life-changing and life-saving solutions for manufacturers in the life sciences and food and beverage industries. Our mission, vision, and core v…
Skills: Process Design, PFD Development, P&ID Development, Process Layouts, Project Management
Atlanta, Georgia, United States · Remote OK
Who We Are QGenda is redefining healthcare workforce management everywhere care is delivered. We're on a mission to empower the healthcare industry to better onboarding, deploy, and manage their workforce. Over 4,500 hea…
Skills: Case Management, Time Management, Written Communication, Verbal Communication, Detail Oriented
Atlanta, Georgia, United States · On-site
$39/hr–$44/hr
Children’s Cardiology, a subsidiary of Children’s Healthcare of Atlanta, is comprised of more than 60 pediatric cardiologists providing comprehensive services for patients from before birth to age 21 who have…
Skills: Pediatric Echocardiography, Fetal Echocardiography, EKG Performance, Holter Monitor Placement, Patient Care
Atlanta, Georgia, United States · On-site
CERTIFIED NURSE ASSISTANT - Sign on bonus 2500 Join the PruittHealth family, where the health and safety of our workforce is our top priority! We're not only committed to your career, we're committed to the health and sa…
Skills: Patient Care, Compassion, Collaboration, Professionalism, Long-term Care
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The UR Specialist conducts medical necessity reviews using InterQual Criteria to determine appropriate patient class designations. They collaborate with provider teams and the Medical Director to ensure accurate documentation and optimal reimbursement.
Requires an Associate degree in nursing and a valid Georgia RN license. Candidates must have at least 5 years of acute hospital experience or 2 years of utilization review experience.
Be inspired. Be rewarded. Belong. At Emory Healthcare.
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
The Utilization Review (UR) Specialist is a Registered Nurse responsible for conducting thorough medical necessity reviews to assist with determining appropriate patient class designation. The UR Specialist will perform timely and comprehensive reviews of the patient chart utilizing InterQual Criteria accurately in conjunction with the UR Department workflows/processes, clinical nursing judgement, and when necessary, discussions with the provider team and/or Medical Director of UR.
Operational Support:
1. Conducts thorough medical necessity reviews to assist with determining appropriate patient class designation. 2. Performs timely and comprehensive reviews of the patient chart utilizing InterQual Criteria accurately in conjunction with the UR Department workflows/processes, clinical nursing judgement, and when necessary, discussions with the provider team and/or Medical Director of UR. 3. Performs appropriate and accurate initial, admission (episode day one) and concurrent utilization reviews as guided by InterQual Criteria and UR Department workflows on all observation, inpatient, and extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department's processes. 4. Ensures that all InterQual reviews are supported with provider team documentation and/or clinical data. 5. When appropriate, the UR Specialist will utilize the UR Department's Severity of Illness/Intensity of Service template to document the medical necessity of the admission or continued stay. 6. While conducting utilization reviews, will identify any Avoidable Delays and accurately document the delay(s) based on the workflow. 7. Follow the UR Department's denial workflows as appropriate. 8. Prioritizes work with minimal guidance for optimal reimbursement and to avoid financial risk to both patient and hospital.
Compliance:
1. Will identify and complete Medicare Outpatient Observation Notices (MOON), Medicare Change of Status Notice (MCSN), Condition Code 44s and Medicare Hospital Issued Notices of Non-Coverage (HINNs) for Medicare beneficiaries as appropriate. 2. Ensures compliance with all state of Georgia and Federal regulatory requirements as designated in Emory Healthcare's Utilization Management Plan. 3. Maintains all required annual competencies, metrics, and fully participate and engage in department process improvements.
Collaboration:
1. Responsible for timely communication to the provider team and interdisciplinary team as it relates to patient class designation and medical necessity of an admission or continued stay on individual patient basis based on UR Department workflows. 2. In a team effort, the UR Specialist will work closely with the UR Department's Case Management Authorization Specialist IP to ensure that authorized days and patient actual LOS are reconciled to ensure appropriate reimbursement for services provided. 3. Responsible for communicating medical necessity denials for in-house patients to the Medical Director of UR, and when designated to the provider team. 4. Serves as a resource to the provider team, Interdisciplinary Care Team, and patient to explain external UR regulations. 5. Provides effective and efficient proactive communication to internal and external customers. 6. Assists in collaborative efforts with the Case Management Department, Revenue Cycle, Physician Advisors, and other required departments.
Additional Duties:
1. Ability to multi-task in a fast-paced environment while efficiently handling multiple priorities and ensuring deadlines are met. 2. Performs other duties and tasks as assigned.
Travel: Less than 10% of the time may be required.
Work Type: This position is a remote position outside traditional office, often from home or another remote setting. Minimum Qualifications:
Education - Associate degree in nursing.
Experience - Minimum of 5 years of recent acute hospital experience or a minimum of two years of previous utilization review experience.
Licensure - Must have a valid, active unencumbered Registered Nurse license approved by the Georgia Licensing Board.
Skills - Must meet all quality and productivity expectations and successfully complete yearly competencies.
Preferred Qualifications: Education - Bachelor's degree in Nursing strongly preferred. Certification - Case Management certification preferred. Skills - InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred.
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at [email protected]. Please note that one week's advance notice is preferred.
The frontline of care. The forefront of discovery.
At Emory Healthcare, we deliver world-class patient care, drive cutting-edge research and foster a culture of excellence and compassion. Our teams combine expertise, innovation and humanity to improve lives every day — inside the hospital and beyond.
Offices: Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322, US · Emory University Hospital Midtown, 550 Peachtree Street NE, Atlanta, GA 30308, US · Emory University Orthopaedics & Spine Hospital, 1455 Montreal Road, Tucker, GA 30084, US · Emory Saint Joseph's Hospital, 5665 Peachtree Dunwoody Road, Atlanta, GA 30342, US · Emory Johns Creek Hospital, 6325 Hospital Parkway, Johns Creek, GA 30097, US
There are currently 3,341 open healthcare positions in Atlanta, GA listed on Clera. New openings are added daily as companies post roles.
Companies currently hiring include Emory Healthcare, Northside Hospital, Emory University Department of Economics, Piedmont HealthCare, Children's Healthcare of Atlanta, among others. Browse the listings above to see every active employer.
Yes — 693 of the 3341 open healthcare positions offer remote or hybrid work (271 remote, 422 hybrid).
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