Registered Nurse, UR specific certification preferred (CCM, ACM, CPUR) * Educational Requirements: Bachelors Degree * Minimum Experience: Minimum of 7 years UR with progressive Revenue Cycle ...
Registered Nurse, UR specific certification preferred (CCM, ACM, CPUR) * Educational Requirements: Bachelors Degree * Minimum Experience: Minimum of 7 years UR with progressive Revenue Cycle ...
... and will be hybrid or remote. The office is located at One Century Plaza, Nashville, TN ... Associate's degree in Nursing with an active RN license. * Required Work Experience : 5 years ...
New
... and will be hybrid or remote. The office is located at One Century Plaza, Nashville, TN ... Associate's degree in Nursing with an active RN license. * Required Work Experience : 5 years ...
New
Review and approve APP, RN, SW and PharmD plans of care. * Review, approve and co-sign APP ... This position will be remote within the designated market with occasional in-home patient treatment ...
Review and approve APP, RN, SW and PharmD plans of care. * Review, approve and co-sign APP ... This position will be remote within the designated market with occasional in-home patient treatment ...
Licensed Psychologist- Remote
Atlanta, GA · Remote
$650/wk
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
Licensed Psychologist- Remote
Atlanta, GA · Remote
$650/wk
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
VAERS Clinician
Atlanta, GA · On-site +1
Clinical background (e.g. physician assistant, nurse practitioner, registered nurse); MD's are ... Work Location Remote (onboarding will occur at the CDC in Atlanta, GA) About Lukos Lukos delivers ...
VAERS Clinician
Atlanta, GA · On-site +1
Clinical background (e.g. physician assistant, nurse practitioner, registered nurse); MD's are ... Work Location Remote (onboarding will occur at the CDC in Atlanta, GA) About Lukos Lukos delivers ...
Review and approve APP, RN, SW, and PharmD plans of care. * Review, approve, and co-sign APP ... This position will be remote within the designated market with occasional in-home patient treatment ...
Review and approve APP, RN, SW, and PharmD plans of care. * Review, approve, and co-sign APP ... This position will be remote within the designated market with occasional in-home patient treatment ...
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Licensed Professional Counselor- Remote
Atlanta, GA · Remote
$650/wk
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
Licensed Professional Counselor- Remote
Atlanta, GA · Remote
$650/wk
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Review and approve APP, RN, SW, and PharmD plans of care. * Appropriately and timely document ... This position will be remote within the designated market with occasional in-home patient treatment ...
Review and approve APP, RN, SW, and PharmD plans of care. * Appropriately and timely document ... This position will be remote within the designated market with occasional in-home patient treatment ...
Review and approve APP, RN, SW, and PharmD plans of care. * Ensure appropriate and timely patient ... This position will be remote within the designated market with occasional in-home patient treatment ...
Review and approve APP, RN, SW, and PharmD plans of care. * Ensure appropriate and timely patient ... This position will be remote within the designated market with occasional in-home patient treatment ...
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Licensed Marriage and Family Therapist- Remote
Atlanta, GA · Remote
$650/wk
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
Licensed Marriage and Family Therapist- Remote
Atlanta, GA · Remote
$650/wk
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
The market performance manager will lead a team of nurse practitioners, registered nurses, social ... This position is remote but may require 25% of travel within their given market * Basic Life ...
The market performance manager will lead a team of nurse practitioners, registered nurses, social ... This position is remote but may require 25% of travel within their given market * Basic Life ...
Oncology Account Executive
Macon, GA · Remote
$241K - $311K/yr
Physicians Assistant (PA), Nurse Practitioner (NP) or Registered Nurse (RN) with experience ... Remote
Oncology Account Executive
Macon, GA · Remote
$241K - $311K/yr
Physicians Assistant (PA), Nurse Practitioner (NP) or Registered Nurse (RN) with experience ... Remote
Oncology Account Executive
Atlanta, GA · Remote
$241K - $311K/yr
Physicians Assistant (PA), Nurse Practitioner (NP) or Registered Nurse (RN) with experience ... Remote
Oncology Account Executive
Atlanta, GA · Remote
$241K - $311K/yr
Physicians Assistant (PA), Nurse Practitioner (NP) or Registered Nurse (RN) with experience ... Remote
Medical Assistant, Remote
Atlanta, GA · Remote
$18 - $22/hr
Experience working in a remote setting * Experience making out-bound calls to patients * Strong ... specialty physicians, registered dietitians, nurses, psychologists, and therapists who have ...
Medical Assistant, Remote
Atlanta, GA · Remote
$18 - $22/hr
Experience working in a remote setting * Experience making out-bound calls to patients * Strong ... specialty physicians, registered dietitians, nurses, psychologists, and therapists who have ...
Remote Medical Scribe
Cumming, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
Quick apply
Remote Medical Scribe
Cumming, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
Remote Medical Scribe
Augusta, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
Quick apply
Remote Medical Scribe
Augusta, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
Remote Medical Scribe
Columbus, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
Quick apply
Remote Medical Scribe
Columbus, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...
Remote Medical Scribe
Savannah, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Summary of Position Description: The Scribe-X medical scribe is a critical member ...
Quick apply
Remote Medical Scribe
Savannah, GA · Remote
$14 - $17/hr
Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Summary of Position Description: The Scribe-X medical scribe is a critical member ...
Remote Neuroscience Rn information
What is the highest paid remote nursing job?
Can nurses work in neuroscience?
How to make $300,000 as a nurse online?
How to make an extra 2000 a month as a nurse?
What is the difference between Remote Neuroscience Rn vs Remote Neurology Nurse?
| Aspect | Remote Neuroscience Rn | Remote Neurology Nurse |
|---|---|---|
| Credentials | Registered Nurse (RN), neuroscience-specific certifications | Registered Nurse (RN), neurology certifications |
| Work Environment | Telehealth platforms, hospitals, clinics | Telehealth, outpatient clinics, hospitals |
| Industry Usage | Neuroscience research, patient care, clinical trials | Neurology patient management, post-op care |
Both roles require RN licensure and specialized certifications, with overlapping work environments in telehealth. The main difference lies in their focus: Remote Neuroscience Rn concentrates on neuroscience-specific patient care and research, while Remote Neurology Nurse specializes in general neurology patient management. Understanding these distinctions helps job seekers find the best fit for their skills and interests.

Utilization Management Director - RN Required - Remote
Gainesville, GA • On-site, Remote
Full-time
Posted 13 days ago
Northeast Georgia Health System rating
7.3
Based on 152 frontline employees who took The Breakroom Quiz
305th of 889 rated healthcare providers
Job description
Executive Leadership, Revenue Cycle
Work Shift/Schedule:
8 Hr Morning - Afternoon
Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.
About the Role:
Job Summary
The Director of Utilization Management (UM) is responsible for leading and managing the Utilization Management (UM) functions at Northeast Georgia Medical Center. This position plays a critical role in ensuring correct status assignment, optimizing reimbursement, minimizing denials, improving case mix index (CMI), and ensuring appropriate utilization of hospital resources. The Director works collaboratively with hospital leadership, physicians, case management, finance, and compliance teams to enhance quality reporting, patient outcomes, and financial integrity. This role serves as a key liaison between clinical and financial operations, ensuring a seamless integration of documentation integrity with utilization management to drive efficiency, compliance, and revenue cycle optimization.
Minimum Job Qualifications
- Licensure or other certifications: Registered Nurse, UR specific certification preferred (CCM, ACM, CPUR)
- Educational Requirements: Bachelors Degree
- Minimum Experience: Minimum of 7 years UR with progressive Revenue Cycle leadership experience of 2 or more years.
- Other:
Preferred Job Qualifications
- Preferred Licensure or other certifications:
- Preferred Educational Requirements: Master's Degree in Nursing or other health related field preferred
- Preferred Experience:
- Other:
Job Specific and Unique Knowledge, Skills and Abilities
- Proven ability to lead teams, manage budgets, and implement strategic initiatives.
- Strong ability to educate and influence physicians, staff, and leadership on UM best practices.
- Experience in data analysis, KPI tracking, and performance improvement strategies.
- Expertise in medical necessity criteria, payer regulations, and revenue cycle principles.
- Oversee day-to-day operations of the Utilization Management Department, ensuring compliance with payer requirements and regulatory standards.
- Work closely with case management, managed care, and patient financial services to streamline utilization review and enhance hospital financial performance.
- Monitor and analyze key performance indicators (KPIs), financial goals, and length of stay (LOS) metrics to drive performance improvements.
- Recruit, train, and manage a high-performing UM team, ensuring operational alignment with hospital objectives.
- Manage departmental budgets, ensuring financial responsibility and resource allocation
- Develop and implement performance metrics to evaluate team effectiveness and drive continuous improvement.
- Foster strong relationships with internal and external stakeholders, including hospital executives, physicians, and payers.
- Provide data-driven insights and strategic recommendations to hospital leadership regarding UM performance.
- Act as the operational leader for process improvement initiatives related to utilization management, and revenue cycle optimization.
- Work closely with Physician Advisors to develop and revise policies and procedures related to clinical status determination, medical necessity, denials and appeals, and physician education.
- Review daily, weekly and monthly reports to monitor and analyze performance of UM departments, assess data against KPI standards and goals, and identifies trends to make adjustments as indicated. Keeps leadership, staff, and clinical staff (where appropriate) informed.
- Oversees UM working closely with Case Management and other members of the interdisciplinary team to ensure effective collaboration for length of stay and throughput.
- Communicate with and educate physicians and other key stake holders regarding Utilization Review policies, practices, and procedures to ensure safe, effective services, along with appropriate transitions of care.
- Assesses departmental workload to determine appropriate staff allocations to ensure productivity standards are being met consistently.
- Works closely with physicians and staff to provide and monitor clinical/financial data for the purpose of improving hospital/physician performance and anticipating payer and managed care demands.
- Actively participates as the operational leader for UM in committees including but not limited to MRUR; Compliance; Policy and Procedures; and Quality
- Identifies and maintains good relationships with other departments such as Managed Care, Patient Financial Services, Patient Access, and others so to facilitate the utilization review processes and to provide continuity of care.
- Weight Lifted: Up to 20 lbs, Frequently 31-65% of time
- Weight Carried: Up to 20 lbs, Frequently 31-65% of time
- Vision: Moderate, Frequently 31-65% of time
- Kneeling/Stooping/Bending: Occasionally 0-30%
- Standing/Walking: Constantly 66-100%
- Pushing/Pulling: Constantly 66-100%
- Intensity of Work: Occasionally 0-30%
- Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving
Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.
NGHS: Opportunities start here.
Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.
What Northeast Georgia Health System employees say
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Benefits
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About Northeast Georgia Health System
Sourced by ZipRecruiter
Northeast Georgia Health System (NGHS) is a not-for-profit community health system dedicated to improving the health and quality of life of the people of Northeast Georgia. Through the services of a medical staff of more than 800 physicians, the residents of Northeast Georgia enjoy access to the state’s finest and most comprehensive medical services. It is our mission to improve the health of our community in all we do.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Gainesville, GA, US
Year founded
1951