Utilization review nurse jobs in Georgia

Join in Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future. As an RN, your dedication to holistic, patient-centered care in your community is deeply valued. Piedmont supports nurses with the compensation, work/life balance, and resources they deserve. You'll work in a positive, collaborative environment alongside dedicated team members, and use state-of-the-art technology that strengthens patient care and services. You may participate in clinical research that opens doors to working on the forefront of medical advances and changes patient lives. Apply today to make a positive difference in every life you touch. Responsibilities: The staff nurse provides nursing care to patients from birth through the lifecycle utilizing nursing processes to assess, plan, implement, and evaluate the care for patients. He/she functions within the framework of the policies and procedures of the organization and demonstrates professional growth and accountability. The staff nurse is responsible for maintaining standards of practice, coordinating patient care activities of all assigned staff in the provision of quality nursing care. Qualifications: MINIMUM EDUCATION REQUIRED: Graduate of a nursing program MINIMUM EXPERIENCE REQUIRED: New Graduates of a nursing program eligible MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW: Current License in the State of Georgia as a Registered Nurse or NLC/eNLC Multistate License.BLS certification required. ADDITIONAL QUALIFICATIONS: For PRN positions: One year of nursing experience in a hospital setting is required Bachelor's degree preferred Advanced certification in field of specialty, if applicable (see addendum) Nursing Experience in Hospital Setting Preferred ESSENTIAL FUNCTIONS: 1. Performs patient assessments to include collection of data regarding the patient's physical, psychosocial and health history.2. Appropriately evaluates the developmental age of the patient when performing assessments, treatments and patient/family education.3. Organizes patient data into the formulation of a plan of care; identifies additional information needed and makes care decisions based on identified needs. Identifies expected patient outcomes.4. Carries out plan of care to achieve desired patient outcomes.5. Provides patient care that is specific to the setting, identified needs and plan; ensures that the care provided is appropriate to the severity of the disease, condition, impairment or disability.6. Oversees activities of ancillary and support team members.7. Identifies teaching opportunities and provides the resources necessary for achieving the educational goals of the patients.8. Communications issues/concerns to the Charge Nurse, Clinical Manager and/or physician as appropriate.9. Documents patient care and concerns in the patient record. KNOWLEDGE, SKILLS, ABILITIES Leadership SkillsEffective Communication SkillsInitiativeIndependent JudgmentAbility to handle stressful environments Business Unit : Name: Eastside Medical Center LLC

We're seeking experienced **Utility Management Nurses** to support a client's healthcare product development by leveraging expertise in **insurance coding and hospital revenue management workflows**. This role involves collaborating with hospital systems to align medical documentation with insurance policies, ensuring accurate coding and optimal reimbursement outcomes. ### **Key Responsibilities** - **Insurance Coding & Revenue Cycle Alignment:** Review, audit, and optimize insurance coding practices across hospital systems to ensure compliance and maximize reimbursement accuracy. - **Workflow Analysis:** Evaluate existing revenue management workflows and recommend improvements tailored to client's AI-driven documentation tools. - **Clinical Data Interpretation:** Translate complex clinical notes into standardized coding formats (ICD-10, CPT, HCPCS) aligned with payer policies. - **Policy Matching:** Assess coding accuracy against insurance guidelines and payer documentation requirements. - **Product Development Collaboration:** Work closely with client's engineering and product teams to refine AI models that automate or assist with medical coding and documentation. - **Compliance & Quality Assurance:** Ensure alignment with HIPAA, CMS, and payer-specific coding regulations. ### **Required Qualifications** - **Licensure:** Registered Nurse (RN) or equivalent clinical background. - **Experience:** Minimum 3-5 years in **medical coding**, **clinical documentation improvement (CDI)**, or **revenue cycle management**. - **Certifications:** CPC, CCS, or CRC certification preferred. - **Domain Expertise:** Familiarity with **hospital billing systems**, **payer policy interpretation**, and **coding audit procedures**. - **Analytical Skills:** Strong understanding of clinical documentation standards and payer logic. - **Tech Savvy:** Comfortable working with EHR systems (Epic, Cerner, Meditech) and documentation review software. ### **Preferred Qualifications** - Experience working within **hospital revenue integrity teams** or **insurance utilization management**. - Exposure to **AI-powered healthcare documentation tools** or **automated coding systems**. - Ability to identify and flag edge cases or policy exceptions in automated workflows. - Strong collaboration skills with cross-functional (engineering, compliance, and data) teams. ### **Engagement Model** - **Contract / Part-time (Remote/In person)** - Flexible hours with collaboration during U.S. business hours. In person in San Francisco is a plus

locations1800 Parkway Centertime type Part timeposted on Posted 30+ Days Agojob requisition id JR-37247 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Job Summary: The Magnet Nursing Consultant Center for Nursing Excellence (CFNE) works independently and collaboratively with the CFNE leadership team to identify needs, determine appropriate interventions, implement strategies, support department initiatives and special projects aligned with shared leadership, nursing education, nursing excellence, technology platforms, nursing research and evidence-based practice (EBP). Based on project needs, the work scope may include identification, development, implementation, and/or project evaluation; and/or project management support including guidance, timeline development, progress tracking, feedback, sustainability options, and handoff. This role serves as a collaborative partner with stakeholders, and their teams associated with the defined scope to address key responsibilities. The role purpose is to advance Wellstar nursing through interprofessional and interdisciplinary partnerships; professional growth and development; influencing nurses professional practice ownership; supporting nursing research; implementing EBP; mentoring; and supporting a culture of nursing excellence. The Nurse Consultant CFNE position reports directly to Assistant Vice-President, Nursing Practice and Operations and/or designee. Key responsibilities of the role include: 1. Advisory, consultative, strategic and operational support for special projects 2. Advisory, consultative, strategic and operational support ANCC Magnet, Pathway to Excellence, Practice Transition Accreditation Program (PTAP) journeys 3. Advisory, consultative, strategic and operational support nursing research, EBP, quality improvement (QI), and lean projects 4. Advisory, consultative, strategic and operational support nursing professional development It is expected that the Nurse Consultant work is aligned with overall Wellstar Health System mission, vision, and values and Nursing's mission, vision, and values, the nursing professional practice model, and the nursing care delivery model It is expected that the Nurse Consultant is licensed, knowledgeable, and upholds the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. Core Responsibilities and Essential Functions: 1. Advisory, consultative, strategic and operational support for special projects a. Identification, development, implementation, and/or project evaluation b. Project management support including guidance, timeline development, progress tracking, feedback, sustainability options, and/or handoff c. Provide guidance and support to nursing professional governance 2. Advisory, consultative, strategic and operational support ANCC Magnet and Pathway to Excellence journeys a. Review, make recommendations, and edit stories by facility nurses addressing designation standards b. Assist with strategic planning by facility to address gaps and gap closures c. Assist with annual and mid-cycle reports based on designation standards d. Support submission of documents into the technology platform for submission e. Assist with requested supplemental evidence if requested by the appraisers f. Participates as a member of Magnet and Pathway to Excellence system steering committees 3. Advisory, consultative, strategic and operational support Nursing research and evidence-based practice (EBP) a. Participates as a member of system nursing research and EBP committee b. Member of academic practice partnership committee(s) with a focus on nursing research and EBP c. Conduct and/or support nursing research studies from development thru dissemination d. Review, edit, provide feedback on research and EBP studies submitted for Institutional Review Board (IRB) review . Advisory, consultative, strategic and operational support nursing professional development a. Guidance, review, and support development of learning needs assessments for nurses at all levels within the facilities, ensuring alignment with professional nursing standards and evidence-based content 5. Advisory, consultative, strategic and operational support Practice Transition Accreditation Program (PTAP) redesignation journey: a. Assist with strategic planning by system and facilities to address PTAP standards, identify gaps, and gap closures b. Review, make recommendations, and edit stories by Nurse Residency Program (NRP) leaders and facility nurses addressing designation standards c. Guidance and assistance with the annual and mid-cycle reports based on annual requirements in designation standards d. Support submission of documents into the technology platform for submission e. Assist with requested supplemental evidence if requested by the appraisers Performs other duties as assigned Complies with all WellStar Health System policies, standards of work, and code of conduct. Required Minimum Education: Master's Degree Graduate degree in Nursing and current Nursing Doctoral Candidate (PhDc or DNPc) Required Doctorate Preferred Education: Doctoral degree in Nursing (PhD or DNP) Preferred Required Minimum License(s) and Certification(s): All certifications are required upon hire unless otherwise stated. RN - Multi-state Compact or Reg Nurse (Single State) Additional License(s) and Certification(s): NEA-BC, NPD-BC, or ANCC-recognized national nursing practice specialty certification Preferred Required Minimum Experience: Minimum 10 years Nursing leadership experience and content expertise with demonstrated evidential outcomes Required Required Minimum Skills: Excellent verbal and written communication skills. Ability to communicate with various members of the healthcare team. Ability to use Microsoft products. Epic and SPSS experience highly preferred. Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.

Kaiser Permanente nurses are guided by an integrated nursing model that places patients and families in the center. The Staff Registered Nurse (RN) III practices professional nursing as defined by the Georgia Registered Professional Nurse Practice Act and by organizational policies, procedures, and guidelines. Provides nursing care for patients, members, and families to promote or restore health and to prevent illness and injury. Collaborates with members of the Health Care Team (HCT) and leaders to ensure the delivery of high quality, safe, effective, and efficient care. Essential Responsibilities: Utilizes the nursing process to assess patient health status, determine nursing diagnosis, establish nursing goals, and develop, implement, and evaluate the nursing plan of care. Completes POE and addresses care gaps during the patient encounter. Accurately documents patient data, actions, interventions, and response to treatment according to established policies and guidelines. Assists with procedures and monitors patients response during and after the procedure. Actively participates, as a member of the healthcare team, to engage patients, families, and caregivers in the coordination of patient care. Leads the nursing response to medical emergencies. Monitors electronic messaging and emails (department InBasket) related to patient or provider requests and manages the messages or triages them to physician, associate practitioner, or others as needed. Initiates and monitors IV therapy, administration of medications, and other nursing procedures as prescribed by the physician or associate practitioner, and documents accordingly. Assesses patient and family health education needs, provides health teaching and counseling, and evaluates effectiveness of the education process. Conducts outgoing telephone calls to patients requiring follow-up care and preventative outreach. Participates in quality improvement activities and/or initiatives. Participates in departmental orientation, training, and competency validation of new staff (after completion of validator training). Leads departmental or regional performance improvement initiatives (access, quality, service, people). Autonomously perform procedures under provider supervision and evaluate patients response during and after the procedure. Serves as a preceptor, resource, and mentor for new members of the healthcare team and nursing students. Provide at least one (1) training in-service each year. Seeks and completes formal continuing education relevant to clinical discipline. Utilizes advanced skills to provide patient care, education, and consultation. Autonomously perform procedures under physician supervision, such as cardiac stress tests, RN sonography, conscious sedation, or chemotherapy infusions. May perform other duties as assigned. Basic Qualifications: Experience Minimum three (3) years of current RN clinical experience. Minimum two (2) years of clinical experience in area of specialty. Education Associates degree in nursing. High School Diploma or General Education Development (GED) required. License, Certification, Registration Registered Professional Nurse License (Georgia) required at hire Basic Life Support required at hire Additional Requirements: N/A. Preferred Qualifications: Specialty Certification at time of hire or within 1 (one) year preferred. Bachelors (BSN) degree.

Medical Solutions is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Albany, GA. Shift: 3x12 hr days Start Date: ASAP Duration: 17 weeks A facility in Albany, GA is seeking its next amazing RN (Registered Nurse) to work in Med Surg (Medical Surgical). Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you hone your skills and build an amazing resume. When you work with Medical Solutions, we've got your back 100% - starting with your co-captain and sidekick, your trusty recruiter. In addition to providing the industry's best recruiters, we offer tons of high-paying jobs, clinical support, and incredible benefits, including: ~ 1,000 unlimited referral bonus ~Paid, private, pet-friendly housing ~ Licensure/certification reimbursement ~ Free employee assistance program (EAP) ~ Day-one medical, dental, and vision insurance ~24/7 customer care ~ BLS About Medical Solutions: Since 2001, Medical Solutions has made it our mission to provide "Service That Inspires" to our Travel Nurses, our Hospital Clients, and our internal employees. As a result, we're considered one of the most respected brands in the healthcare staffing industry, with thousands of Hospital Clients nationwide and an extensive network of skilled clinicians. Travel Nurses can expect the best service in the industry with Recruiters who are invested in their professional and personal success.

FlexCare is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Albany, GA. Shift: 4x12 hr nights Start Date: 01/05/2026 Duration: 17 weeks Pay: $2450.32 / Week Profession: RN Facility Type: Teaching Facility & Level II Trauma Center Assignment Type: Travel Extra ways to earn through bonuses FlexCare's robust benefits package for all travel assignments includes: ~ Medical, Dental, and Vision Insurance ~ Flexible Spending Account and Dependent Care Flexible Spending Account ~FlexCare is an award-winning nationwide leader in travel nursing, allied health, and therapy talent management solutions for top healthcare facilities throughout the U.Since 2006, FlexCare has been committed to helping address critical personnel needs in healthcare, ensuring facilities have access to the best clinical talent to meet patient needs while unlocking career opportunities for travel clinicians and supporting them to provide the highest level of patient care possible. For clinicians, we open doors to rewarding travel assignments with top facilities nationwide, backed by dedicated support every step of the way. For healthcare facilities, we provide access to exceptional talent when and where they need it most. We are more than a staffing agency - we're a trusted healthcare partner who builds meaningful relationships to improve lives, advance careers, and set the standard for excellence in healthcare talent management. Single Point of Contact for All You Need: Our clinicians always have a dedicated recruiter who handles everything, saving them time, reducing their stress, and building lasting relationships. ~ Fast-Track to Travel Platform: Our platform offers our clinicians an all-in-one hub for finding assignments, managing credentials, and streamlining their travel careers. ~Award-Winning Team That Goes Above & Beyond: Our clinicians have an entire team of healthcare experts, ranked top in the industry, to support their success, from payroll to clinical support to compliance. FlexCare pushes beyond healthcare staffing through our high-touch, high-results approach. We're leaders in healthcare talent management who focus on what matters most - matching the right clinicians with the right facilities to deliver quality patient care. FlexCare's robust benefits package for all travel assignments includes: ~ Medical, Dental, and Vision Insurance ~ Flexible Spending Account and Dependent Care Flexible Spending Account ~

Fusion Medical Staffing is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Decatur, GA. Shift: Inquire Start Date: 01/12/2026 Duration: 13 weeks Pay: $1991 / Week Hit Apply below to send your application for consideration Ensure that your CV is up to date, and that you have read the job specs first. Travel ICU RN Fusion Medical Staffing Facility in Decatur, Georgia Job Details Fusion Medical Staffing is seeking a ICU RN for a 13-week travel assignment in Decatur, Georgia. One year of recent experience as an ICU RN Valid RN license in compliance with state regulations Critical Care Registered Nurse (CCRN) certification Summary: The ICU Registered Nurse is responsible for providing comprehensive, critical care to patients in the intensive care unit. This role encompasses assessing and monitoring critically ill patients, operating life-support equipment, administering advanced treatments, and collaborating with multidisciplinary healthcare teams. The position requires strong critical care skills, advanced clinical judgment, excellent communication, and a commitment to maintaining the highest standards of patient safety and professional ethics in high-acuity settings. Administer complex medications and treatments in accordance with approved critical care nursing techniques Operate and manage advanced life support equipment Ensure patient safety and comfort in high-acuity ICU environments, addressing physical and emotional needs Perform and interpret advanced hemodynamic monitoring, including arterial lines, central venous pressure, and pulmonary artery catheters Accurately document all assessments, interventions, and patient responses in the medical record in a timely manner to ensure continuity of care and compliance with regulatory standards Provide education to patients and families regarding the ICU environment, treatments, and recovery expectations Communicate closely with interdisciplinary healthcare teams to optimize patient care Maintain proficiency in critical care procedures and technologies through ongoing education and training Adhere to strict infection control protocols to protect immunocompromised patients and reduce risks Engage in quality improvement initiatives to enhance ICU patient outcomes and operational efficiency Adhere to hospital safety protocols, infection control guidelines, and regulatory standards The ability to read, write, and communicate in the English language Physical Abilities - Must be able to remain in a stationary position, move about, move equipment (50-100lbs), push, pull, and bend Technical/Motor Skills - Must have the ability to grasp, perform fine manipulation, push/pull, and move about when assisting with procedures and/or using department equipment Mental Requirements - Must be able to cope with frequent contact with the general public and customers while meeting deadlines under pressure. Must be able to work under close supervision occasionally, as well as working without assistance from other personnel. Sensory - Must possess visual acuity and ability to effectively communicate Highly competitive pay for travel professionals ~ Comprehensive medical, dental, and vision insurance with first day coverage ~ Life and Short-term disability offered ~Aggressive Refer-a-friend Bonus Program ~Reimbursement for licensure and CEUs At Fusion Medical Staffing, our goal is to improve the lives of everyone we touch, and we're always looking for people like you to join our mission. Your passion for helping others deserves a partner just as committed to supporting you - that's why we offer day one insurance, $0 copay for mental health services, scholarships and awards, exclusive discounts, and more. From your personal recruiter to our clinical and traveler experience teams, we're here to guide and celebrate you along your journey. You take care of others; we take care of you. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Start your rewarding career as a Travel ICU RN with Fusion Medical Staffing and join our mission to improve lives. Fusion is an EOE/E-Verify Employer About Fusion Medical Staffing: Fusion Medical Staffing provides career opportunities to healthcare professionals by helping medical facilities fill their staffing needs. xevrcyc Fusion staffs a variety of specialties within the nursing and allied healthcare fields. Specialty Fields: Home Health Long Term care Nursing Radiology Therapy

Job DescriptionAbout The Strickland Group: The Strickland Group is a family-driven, vision-first financial services agency helping families protect and build wealth through life insurance and retirement solutions. This is a 100% commission, remote role with flexible hours, mentorship, and a clear path to agency ownership. You'll meet with warm leads, uncover needs, present options, and help clients put protection in place. Training is provided; no experience required, but strong work ethic, coachability, and a desire to grow are musts.

Alliant Health Group is a family of companies that provides professional services supporting the effective administration of healthcare programs and funding to support healthcare improvement initiatives. Alliant Health Solutions provides Federal and state government entities with the services, expertise and information systems necessary to increase the effectiveness, accessibility and value of health care. Currently, Alliant Health Solutions, a "2025 Best Place to Work and Healthiest Employer", seeks a Review Nurse. The Review Nurse conducts prior approval and precertification reviews for Georgia Fee-for-Service Medicaid members for the team's defined review types while meeting and exceeding contract expectations. The primary responsibilities of the Nurse Reviewers are listed below: In this role, the ideal candidate will : Perform reviews of provider prior approval/precertification requests as per PAUM policy and procedures Evaluate initial clinical information and approve cases that meet criteria. Document clearly the rationale for all review decisions using appropriate criteria or nursing judgment Refer cases that do not meet criteria and cannot be approved by InterQual criteria or nursing judgment to a Referral Nurse Coordinator who in turn assures review by a Peer Review Consultant on any case which a nurse cannot approve Consult with the Manager, Supervisor PA/UM, or Medical Directors on issues related to Peer Consultant review decisions or cases requiring physician clarification Participate in quality improvement and peer review activities Maintain confidentiality of review information and medical records in accordance with HIPAA compliance, and Alliant Policy Work in close collaboration with other team members to support the development of new projects and continuous improvement of the overall work process within the team Promote core values of teamwork, professionalism, effective communication skills and positive behaviors Maintain security and confidentiality of all information in accordance with HIPAA laws, URAC regulations, and company policies Demonstrate compliance with the corporate and departmental policies as evidenced by attendance, punctuality, and dress Perform other duties as assigned Knowledge, skills and abilities required for this role include: Knowledge of ICD-10-CM, CPT codes, and InterQual criteria preferred Knowledge of clinical theory and problem-solving skills Strong organizational skills with ability to demonstrate the work priorities Excellent interpersonal, written, and verbal skills required Knowledge, skill and ability to perform work with considerable independence by use of creative thinking, thorough analysis of problems, and use of innovative approaches to problem resolution Computer literate, experience with MS Windows products Ability to type 30-50 words per minute Ability to travel by car or plane to Company locations, customer meetings or other locations as needed Education, experience and training required and preferred for the position are below: Required: Registered Nurse, with at least three years of recent clinical experience required Current and unencumbered Georgia nursing license required Preferred: Utilization Review or Prior Approval Precertification experience Alliant offers work/life balance and great benefits including medical, dental life, disability, paid-time off, retirement with match and contribution, disability, employee assistance program, parental leave, and more. If interested, click the apply icon above to apply. Alliant Health Group and subsidiaries, dba Alliant Health Solutions ("the Company) is an Equal Opportunity Employer and Drug Free Workplace. In compliance with the American's with Disability Act (ADA) and Amendments Act (ADAAA), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity, national origin, disability or veteran status. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, please let us know. Likewise, if you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact ************.

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work Schedule: Monday to Friday from 11:30 AM to 8:00 PM EST. * This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria. The Nurse Case Manager II is responsible for care management within the scope of licensures for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Perform duties telephonically or on-site such as at hospitals for discharge planning. How you will make an impact: * Ensures member access to services appropriate to their health needs. * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implement care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Negotiate rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues. * Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current unrestricted RN license in applicable state(s) required. * Multi-state licensure is required if this individual provides services in multiple states. Preferred Experience, Skills, and Capabilities: * Case Management experience preferred. * Certification as a Case Manager preferred. * Managed Care experience preferred. * Ability to talk and type at the same time preferred. * Demonstrate critical thinking skills when interacting with members preferred. * Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly preferred. * Ability to manage, review and respond to emails/instant messages in a timely fashion preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $76,944 to $120,912. Locations: Colorado; Illinois; Nevada In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

About Us: Palmetto Infusion provides comprehensive ambulatory and home-based infusion services to both acute and chronically ill patients. Our centers care for people by providing patients and their families with a convenient, affordable, and safe place to receive infusion treatments. We strive for more than personal service - always delivering a warm and attentive health care experience that boosts patients' state-of-mind, improves their health, and quality of life. At Palmetto Infusion, we believe in creating an experience that goes beyond just a job. It's about being part of something bigger than yourself - a connected group of caretakers who work together to restore health and hope to our patients. We call it The Palmetto Experience, and we believe it's what sets us apart from other employers. For our employees, The Palmetto Experience means we serve and support people in our purpose to restore health and hope, we build a culture of belonging and collaboration, we deliver on our promise to treat people with respect and empathy, and we strive to embrace change and search for new opportunities. About the Role: The Clinical Nurse Liaison (CNL) position is a multifaceted registered nurse position with responsibilities to sales and marketing and to clinical operations. The CNL is responsible for developing and fostering long term relationships between Palmetto Infusion's Home Infusion service-line and the Health Care Community in which it serves in order to achieve established territory financial goals. In addition, the CNL coordinates patient care requirements between the home infusion pharmacy, the healthcare agency, provider, or its representative, and the patient. Schedule: Monday - Friday; 8:00 AM - 5:00 PM. Service Areas: Macon, GA and may travel to other regions as needed. Minimum Qualifications: Experience/Education: * BACHELOR OF SCIENCE IN NURSING with 3 years of direct pt. care experience or ASSOCIATES DEGREE IN NURSING with 5 years of direct patient care experience in a clinical setting, or a minimum of 3 years of direct patient care experience in an acute care, ambulatory infusion, home infusion, or home health setting. * Active Registered Nurse license in the state(s) of practice. * 3 to 5 years of nursing experience. * BLS. * Proficient at partner programs (i.e.: MS Outlook, Word, Excel). * Ability to cope with ambiguous, changing environment while under pressure in a calm manner. * Must be able to work as a team member and develop productive and cooperative working relationships with all members of the Palmetto Infusion team. Essential Functions: Sales and Marketing: * Performs all phases of sales and marketing activities for assigned territory. * Account focus includes hospitals, physicians, payors and home health agencies controlled by one or more competitors or those referral sources with minimal account penetration, as well as existing territory business. * Achieves total net revenue and profit (EBITDA) objectives for assigned territory with primary goal of bringing in new business to increase overall market share. * Creates market development plans in concert with company goals/objectives. Secondary Duties, Functions, & Responsibilities (as assigned): Clinical Infusion Services: * Patient assessment, education/teaching, implementation of physician orders, and development and revision of the Plan of Care and/or the Plan of Treatment. * Monitoring patient response to therapy and respond to emergency patient needs. * Communicates to supervisor, physicians and other health care providers, as appropriate, any changes in patients' condition. * Maintains knowledge and proficiency in medical practices through continuing education, staff meetings, and workshops, and home study. * Takes on call responsibility as assigned to provide 24-hour availability according to protocols. About the Benefits: * Competitive Compensation * Comprehensive Medical Insurance * Dental and Vision Insurance * Company Life Insurance * Voluntary Life and Disability Insurance * Additional Voluntary Supplemental Plans * Flexible Spending Account (Medical and Dependent Care) * Health Savings Account * 401K Retirement Plan * Employee Assistance Program (EAP) * Employee Discounts * Ramsey SmartDollar Program * Referral Program * Tuition Assistance * Paid Time Off * 8 Paid Company Holidays Patient Advocacy Statement: At Palmetto Infusion, we believe that patient advocacy is at the heart of everything we do, regardless of our roles within the organization. Each member of our team is dedicated to putting the needs and well-being of our patients first. Whether we're working directly with patients or supporting them behind the scenes, our commitment to being a compassionate advocate is paramount. We understand that every interaction, every decision, and every effort contribute to the quality of care our patients receive. Together, we strive to ensure that every individual feels heard, supported, and empowered throughout their healthcare journey. This dedication to patient-centered care is what creates "The Palmetto Experience" - a standard of excellence that defines us and enriches the lives of those we serve. Physical Demands: * The physical demands described here are representative of those that must be met by an employee to successfully perform the primary functions of this job. While performing the duties of this job, the employee may be required to frequently stand, walk, sit, bend, twist, talk, and hear. There may be prolonged periods of sitting, keyboarding, reading, as well as driving or riding in transport vehicles. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include reading, distance, computer, and color vision. Talking and hearing are essential to communicate with patients, vendors, and staff. OTHER All employees must uphold the confidentiality of protected health information and follow all HIPAA policies. This position has access to sensitive information and a breach of information may be grounds for immediate termination. We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Job DescriptionNANA Healthcare Management manages multiple behavioral health and detoxification treatment centers within the behavioral health industry. With a focus on evidence-based, client-centered treatment programs that offer clients with all levels of need therapeutic interventions in a warm, welcoming environment, NANA Healthcare Management aims to provide clients with care that meets them where they are at and helps them "Be the great person they were always meant to be." NANA Healthcare Management is seeking a Nursing / Medical Compliance Liaison to ensure regulatory readiness and promote quality client care across all facilities in a behavioral health setting. Schedule: 8:30am-5:00pm Pay: $60,000-$65,000 annually Type: Full-time The Nursing/Medical Compliance Liaison audits and monitors medication records, vitals documentation, and nursing notes to ensure regulatory compliance and promote quality client care across all levels of service. This role serves as the bridge between clinical nursing operations and the compliance team. Qualifications: Associate's or Bachelor's degree in Nursing 2+ years of experience in the behavioral health or residential nursing roles LPN / RN licensure in the State of Georgia Knowledge and Training: Adhere to Confidentiality requirements as outlined in 42 CFR, Part 2. Must have the ability to interact with staff in a professional manner. The ability to handle stressful and demanding situations Proficiency in reviewing MARs, vitals, physician orders, and nursing documentation. Familiarity with DBHDD, DCH, Joint Commission, and insurance requirements for nursing compliance. Ability to identify documentation gaps and trends in medication administration and health monitoring. Experience working collaboratively across clinical, nursing, and compliance teams. Strong communication skills and understanding of incident medication error tracking. Knowledge of HIPAA, infection control, and nursing best practices. Job Responsibilities Conduct audits of Medication Administration Records (MARs) for accuracy and completeness. Review and evaluate nursing notes for clinical clarity, compliance, and timeliness. Audit daily vitals logs and flag abnormal or missing data for clinical review. Ensure physician orders and medication changes are documented and transcribed properly. Monitor and track medication errors, omissions, and incidents with follow-up plans. Collaborate with facility nurses and nursing supervisors to resolve compliance issues. Verify documentation of PRNs and follow-up response is complete and appropriate. Ensure lab orders and results are reviewed, documented, and communicated timely. Participate in mock audits and payer review preparation for nursing compliance readiness. Report monthly trends in nursing documentation to the Compliance Director and facility leadership. Benefits: Paid time off Paid Holidays Health insurance Dental insurance Vision insurance Life insurance Team-oriented work environment Powered by JazzHR iU2YBHLTMC

We're seeking experienced **Utility Management Nurses** to support a client's healthcare product development by leveraging expertise in **insurance coding and hospital revenue management workflows**. This role involves collaborating with hospital systems to align medical documentation with insurance policies, ensuring accurate coding and optimal reimbursement outcomes. ### **Key Responsibilities** - **Insurance Coding & Revenue Cycle Alignment:** Review, audit, and optimize insurance coding practices across hospital systems to ensure compliance and maximize reimbursement accuracy. - **Workflow Analysis:** Evaluate existing revenue management workflows and recommend improvements tailored to client's AI-driven documentation tools. - **Clinical Data Interpretation:** Translate complex clinical notes into standardized coding formats (ICD-10, CPT, HCPCS) aligned with payer policies. - **Policy Matching:** Assess coding accuracy against insurance guidelines and payer documentation requirements. - **Product Development Collaboration:** Work closely with client's engineering and product teams to refine AI models that automate or assist with medical coding and documentation. - **Compliance & Quality Assurance:** Ensure alignment with HIPAA, CMS, and payer-specific coding regulations. ### **Required Qualifications** - **Licensure:** Registered Nurse (RN) or equivalent clinical background. - **Experience:** Minimum 3-5 years in **medical coding**, **clinical documentation improvement (CDI)**, or **revenue cycle management**. - **Certifications:** CPC, CCS, or CRC certification preferred. - **Domain Expertise:** Familiarity with **hospital billing systems**, **payer policy interpretation**, and **coding audit procedures**. - **Analytical Skills:** Strong understanding of clinical documentation standards and payer logic. - **Tech Savvy:** Comfortable working with EHR systems (Epic, Cerner, Meditech) and documentation review software. ### **Preferred Qualifications** - Experience working within **hospital revenue integrity teams** or **insurance utilization management**. - Exposure to **AI-powered healthcare documentation tools** or **automated coding systems**. - Ability to identify and flag edge cases or policy exceptions in automated workflows. - Strong collaboration skills with cross-functional (engineering, compliance, and data) teams. ### **Engagement Model** - **Contract / Part-time (Remote/In person)** - Flexible hours with collaboration during U.S. business hours. In person in San Francisco is a plus

FlexCare is seeking an experienced Dialysis Registered Nurse for an exciting Travel Nursing job in Albany, GA. Shift: 3x12 hr days Start Date: 12/15/2025 Duration: 17 weeks Pay: $1898.37 / Week The full job description covers all associated skills, previous experience, and any qualifications that applicants are expected to have. Profession: RN Facility Type: Teaching Facility & Level II Trauma Center Assignment Type: Travel Extra ways to earn through bonuses FlexCare's robust benefits package for all travel assignments includes: ~ Medical, Dental, and Vision Insurance ~ Flexible Spending Account and Dependent Care Flexible Spending Account ~FlexCare is an award-winning nationwide leader in travel nursing, allied health, and therapy talent management solutions for top healthcare facilities throughout the U.Since 2006, FlexCare has been committed to helping address critical personnel needs in healthcare, ensuring facilities have access to the best clinical talent to meet patient needs while unlocking career opportunities for travel clinicians and supporting them to provide the highest level of patient care possible. For clinicians, we open doors to rewarding travel assignments with top facilities nationwide, backed by dedicated support every step of the way. For healthcare facilities, we provide access to exceptional talent when and where they need it most. We are more than a staffing agency - we're a trusted healthcare partner who builds meaningful relationships to improve lives, advance careers, and set the standard for excellence in healthcare talent management. Single Point of Contact for All You Need: Our clinicians always have a dedicated recruiter who handles everything, saving them time, reducing their stress, and building lasting relationships. ~ Fast-Track to Travel Platform: Our platform offers our clinicians an all-in-one hub for finding assignments, managing credentials, and streamlining their travel careers. ~Award-Winning Team That Goes Above & Beyond: Our clinicians have an entire team of healthcare experts, ranked top in the industry, to support their success, from payroll to clinical support to compliance. FlexCare pushes beyond healthcare staffing through our high-touch, high-results approach. xevrcyc We're leaders in healthcare talent management who focus on what matters most - matching the right clinicians with the right facilities to deliver quality patient care. FlexCare's robust benefits package for all travel assignments includes: ~ Medical, Dental, and Vision Insurance ~ Flexible Spending Account and Dependent Care Flexible Spending Account ~

Alliant Health Group is a family of companies that provides professional services supporting the effective administration of healthcare programs and funding to support healthcare improvement initiatives. Alliant Health Solutions provides Federal and state government entities with the services, expertise and information systems necessary to increase the effectiveness, accessibility and value of health care. Currently, Alliant Health Solutions, a "2025 Best Place to Work and Healthiest Employer", seeks a Review Nurse. The Review Nurse conducts prior approval and precertification reviews for Georgia Fee-for-Service Medicaid members for the team's defined review types while meeting and exceeding contract expectations. The primary responsibilities of the Nurse Reviewers are listed below: In this role, the ideal candidate will: Perform reviews of provider prior approval/precertification requests as per PAUM policy and procedures Evaluate initial clinical information and approve cases that meet criteria. Document clearly the rationale for all review decisions using appropriate criteria or nursing judgment Refer cases that do not meet criteria and cannot be approved by InterQual criteria or nursing judgment to a Referral Nurse Coordinator who in turn assures review by a Peer Review Consultant on any case which a nurse cannot approve Consult with the Manager, Supervisor PA/UM, or Medical Directors on issues related to Peer Consultant review decisions or cases requiring physician clarification Participate in quality improvement and peer review activities Maintain confidentiality of review information and medical records in accordance with HIPAA compliance, and Alliant Policy Work in close collaboration with other team members to support the development of new projects and continuous improvement of the overall work process within the team Promote core values of teamwork, professionalism, effective communication skills and positive behaviors Maintain security and confidentiality of all information in accordance with HIPAA laws, URAC regulations, and company policies Demonstrate compliance with the corporate and departmental policies as evidenced by attendance, punctuality, and dress Perform other duties as assigned Knowledge, skills and abilities required for this role include: Knowledge of ICD-10-CM, CPT codes, and InterQual criteria preferred Knowledge of clinical theory and problem-solving skills Strong organizational skills with ability to demonstrate the work priorities Excellent interpersonal, written, and verbal skills required Knowledge, skill and ability to perform work with considerable independence by use of creative thinking, thorough analysis of problems, and use of innovative approaches to problem resolution Computer literate, experience with MS Windows products Ability to type 30-50 words per minute Ability to travel by car or plane to Company locations, customer meetings or other locations as needed Education, experience and training required and preferred for the position are below: Required: Registered Nurse, with at least three years of recent clinical experience required Current and unencumbered Georgia nursing license required Preferred: Utilization Review or Prior Approval Precertification experience Alliant offers work/life balance and great benefits including medical, dental life, disability, paid-time off, retirement with match and contribution, disability, employee assistance program, parental leave, and more. If interested, click the apply icon above to apply. Alliant Health Group and subsidiaries, dba Alliant Health Solutions ("the Company) is an Equal Opportunity Employer and Drug Free Workplace. In compliance with the American's with Disability Act (ADA) and Amendments Act (ADAAA), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity, national origin, disability or veteran status. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, please let us know. Likewise, if you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact ************.

Work location: This field-based role located in the Albany, GA area enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work schedule: Monday - Friday 8:00am to 5:00pm EST with 1 late evening shift 11:00am to 7:30pm EST. The Nurse Case Manager Senior - Field Nurse is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties primarily in the field with some being done telephonically. This position does involve traveling to attend health plan-sponsored events, individual and group presentations. This position does not involve in-home or facility-based visits. How you will make an impact: Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. Coordinates internal and external resources to meet identified needs. Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Assists in problem solving with providers, claims or service issues. Coordinate referrals to local and statewide resources including behavioral health, housing, transportation, and food assistance. Partner with community health organizations, advocacy groups, and outreach teams to strengthen member connections. Plan, coordinate, and deliver educational events in collaboration with community partners, employers, or local health organizations. Provide group-based and one-on-one education on chronic conditions, medication adherence, preventive screenings, nutrition, and self-care. Support initiatives that address health equity and promote culturally responsive care. Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups. May require the development of a focused skill set including comprehensive knowledge of specific disease process or traumatic injury and functions as preceptor for new care management staff. Participates in department audit activities. Minimum requirements: Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state(s) required. Preferred Capabilities, Skills and Experiences: Nursing experience in Home Health, Managed Care, Case Management, or Care Coordination. Case Management Certification. Strong communication and presentation skills. Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

About Us: Palmetto Infusion provides comprehensive ambulatory and home-based infusion services to both acute and chronically ill patients. Our centers care for people by providing patients and their families with a convenient, affordable, and safe place to receive infusion treatments. We strive for more than personal service - always delivering a warm and attentive health care experience that boosts patients' state-of-mind, improves their health, and quality of life. At Palmetto Infusion, we believe in creating an experience that goes beyond just a job. It's about being part of something bigger than yourself - a connected group of caretakers who work together to restore health and hope to our patients. We call it The Palmetto Experience, and we believe it's what sets us apart from other employers. For our employees, The Palmetto Experience means we serve and support people in our purpose to restore health and hope, we build a culture of belonging and collaboration, we deliver on our promise to treat people with respect and empathy, and we strive to embrace change and search for new opportunities. About the Role: The Clinical Nurse Liaison (CNL) position is a multifaceted registered nurse position with responsibilities to sales and marketing and to clinical operations. The CNL is responsible for developing and fostering long term relationships between Palmetto Infusion's Home Infusion service-line and the Health Care Community in which it serves in order to achieve established territory financial goals. In addition, the CNL coordinates patient care requirements between the home infusion pharmacy, the healthcare agency, provider, or its representative, and the patient. Schedule: Monday - Friday; 8:00 AM - 5:00 PM. Service Areas: Duluth, GA and may travel to other regions as needed. Minimum Qualifications: Experience/Education: * BACHELOR OF SCIENCE IN NURSING with 3 years of direct pt. care experience or ASSOCIATES DEGREE IN NURSING with 5 years of direct patient care experience in a clinical setting, or a minimum of 3 years of direct patient care experience in an acute care, ambulatory infusion, home infusion, or home health setting. * Active Registered Nurse license in the state(s) of practice. * 3 to 5 years of nursing experience. * BLS or obtain upon hire. * Proficient at partner programs (i.e.: MS Outlook, Word, Excel). * Ability to cope with ambiguous, changing environment while under pressure in a calm manner. * Must be able to work as a team member and develop productive and cooperative working relationships with all members of the Palmetto Infusion team. Essential Functions: Sales and Marketing: * Performs all phases of sales and marketing activities for assigned territory. * Account focus includes hospitals, physicians, payors and home health agencies controlled by one or more competitors or those referral sources with minimal account penetration, as well as existing territory business. * Achieves total net revenue and profit (EBITDA) objectives for assigned territory with primary goal of bringing in new business to increase overall market share. * Creates market development plans in concert with company goals/objectives. Secondary Duties, Functions, & Responsibilities (as assigned): Clinical Infusion Services: * Patient assessment, education/teaching, implementation of physician orders, and development and revision of the Plan of Care and/or the Plan of Treatment. * Monitoring patient response to therapy and respond to emergency patient needs. * Communicates to supervisor, physicians and other health care providers, as appropriate, any changes in patients' condition. * Maintains knowledge and proficiency in medical practices through continuing education, staff meetings, and workshops, and home study. * Takes on call responsibility as assigned to provide 24-hour availability according to protocols. About the Benefits: * Competitive Compensation * Comprehensive Medical Insurance * Dental and Vision Insurance * Company Life Insurance * Voluntary Life and Disability Insurance * Additional Voluntary Supplemental Plans * Flexible Spending Account (Medical and Dependent Care) * Health Savings Account * 401K Retirement Plan * Employee Assistance Program (EAP) * Employee Discounts * Ramsey SmartDollar Program * Referral Program * Tuition Assistance * Paid Time Off * 8 Paid Company Holidays Patient Advocacy Statement: At Palmetto Infusion, we believe that patient advocacy is at the heart of everything we do, regardless of our roles within the organization. Each member of our team is dedicated to putting the needs and well-being of our patients first. Whether we're working directly with patients or supporting them behind the scenes, our commitment to being a compassionate advocate is paramount. We understand that every interaction, every decision, and every effort contribute to the quality of care our patients receive. Together, we strive to ensure that every individual feels heard, supported, and empowered throughout their healthcare journey. This dedication to patient-centered care is what creates "The Palmetto Experience" - a standard of excellence that defines us and enriches the lives of those we serve. Physical Demands: * The physical demands described here are representative of those that must be met by an employee to successfully perform the primary functions of this job. While performing the duties of this job, the employee may be required to frequently stand, walk, sit, bend, twist, talk, and hear. There may be prolonged periods of sitting, keyboarding, reading, as well as driving or riding in transport vehicles. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include reading, distance, computer, and color vision. Talking and hearing are essential to communicate with patients, vendors, and staff. OTHER All employees must uphold the confidentiality of protected health information and follow all HIPAA policies. This position has access to sensitive information and a breach of information may be grounds for immediate termination. We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. #ZR

NANA Healthcare Management manages multiple behavioral health and detoxification treatment centers within the behavioral health industry. With a focus on evidence-based, client-centered treatment programs that offer clients with all levels of need therapeutic interventions in a warm, welcoming environment, NANA Healthcare Management aims to provide clients with care that meets them where they are at and helps them "Be the great person they were always meant to be." NANA Healthcare Management is seeking a Nursing / Medical Compliance Liaison to ensure regulatory readiness and promote quality client care across all facilities in a behavioral health setting. Schedule: 8:30am-5:00pm Pay: $60,000-$65,000 annually Type: Full-time The Nursing/Medical Compliance Liaison audits and monitors medication records, vitals documentation, and nursing notes to ensure regulatory compliance and promote quality client care across all levels of service. This role serves as the bridge between clinical nursing operations and the compliance team. Qualifications: Associate's or Bachelor's degree in Nursing 2+ years of experience in the behavioral health or residential nursing roles LPN / RN licensure in the State of Georgia Knowledge and Training: Adhere to Confidentiality requirements as outlined in 42 CFR, Part 2. Must have the ability to interact with staff in a professional manner. The ability to handle stressful and demanding situations Proficiency in reviewing MARs, vitals, physician orders, and nursing documentation. Familiarity with DBHDD, DCH, Joint Commission, and insurance requirements for nursing compliance. Ability to identify documentation gaps and trends in medication administration and health monitoring. Experience working collaboratively across clinical, nursing, and compliance teams. Strong communication skills and understanding of incident medication error tracking. Knowledge of HIPAA, infection control, and nursing best practices. Job Responsibilities Conduct audits of Medication Administration Records (MARs) for accuracy and completeness. Review and evaluate nursing notes for clinical clarity, compliance, and timeliness. Audit daily vitals logs and flag abnormal or missing data for clinical review. Ensure physician orders and medication changes are documented and transcribed properly. Monitor and track medication errors, omissions, and incidents with follow-up plans. Collaborate with facility nurses and nursing supervisors to resolve compliance issues. Verify documentation of PRNs and follow-up response is complete and appropriate. Ensure lab orders and results are reviewed, documented, and communicated timely. Participate in mock audits and payer review preparation for nursing compliance readiness. Report monthly trends in nursing documentation to the Compliance Director and facility leadership. Benefits: Paid time off Paid Holidays Health insurance Dental insurance Vision insurance Life insurance Team-oriented work environment

Job Description Alliant Health Group is a family of companies that provides professional services supporting the effective administration of healthcare programs and funding to support healthcare improvement initiatives. Alliant Health Solutions provides Federal and state government entities with the services, expertise and information systems necessary to increase the effectiveness, accessibility and value of health care. Currently, Alliant Health Solutions, a "2025 Best Place to Work and Healthiest Employer", seeks a Review Nurse. The Review Nurse conducts prior approval and precertification reviews for Georgia Fee-for-Service Medicaid members for the team's defined review types while meeting and exceeding contract expectations. The primary responsibilities of the Nurse Reviewers are listed below: In this role, the ideal candidate will: Perform reviews of provider prior approval/precertification requests as per PAUM policy and procedures Evaluate initial clinical information and approve cases that meet criteria. Document clearly the rationale for all review decisions using appropriate criteria or nursing judgment Refer cases that do not meet criteria and cannot be approved by InterQual criteria or nursing judgment to a Referral Nurse Coordinator who in turn assures review by a Peer Review Consultant on any case which a nurse cannot approve Consult with the Manager, Supervisor PA/UM, or Medical Directors on issues related to Peer Consultant review decisions or cases requiring physician clarification Participate in quality improvement and peer review activities Maintain confidentiality of review information and medical records in accordance with HIPAA compliance, and Alliant Policy Work in close collaboration with other team members to support the development of new projects and continuous improvement of the overall work process within the team Promote core values of teamwork, professionalism, effective communication skills and positive behaviors Maintain security and confidentiality of all information in accordance with HIPAA laws, URAC regulations, and company policies Demonstrate compliance with the corporate and departmental policies as evidenced by attendance, punctuality, and dress Perform other duties as assigned Knowledge, skills and abilities required for this role include: Knowledge of ICD-10-CM, CPT codes, and InterQual criteria preferred Knowledge of clinical theory and problem-solving skills Strong organizational skills with ability to demonstrate the work priorities Excellent interpersonal, written, and verbal skills required Knowledge, skill and ability to perform work with considerable independence by use of creative thinking, thorough analysis of problems, and use of innovative approaches to problem resolution Computer literate, experience with MS Windows products Ability to type 30-50 words per minute Ability to travel by car or plane to Company locations, customer meetings or other locations as needed Education, experience and training required and preferred for the position are below: Required: Registered Nurse, with at least three years of recent clinical experience required Current and unencumbered Georgia nursing license required Preferred: Utilization Review or Prior Approval Precertification experience Alliant offers work/life balance and great benefits including medical, dental life, disability, paid-time off, retirement with match and contribution, disability, employee assistance program, parental leave, and more. If interested, click the apply icon above to apply. Alliant Health Group and subsidiaries, dba Alliant Health Solutions ("the Company) is an Equal Opportunity Employer and Drug Free Workplace. In compliance with the American's with Disability Act (ADA) and Amendments Act (ADAAA), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity, national origin, disability or veteran status. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, please let us know. Likewise, if you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact ************.