RN, Utilization & Care Coordination (Home Health)

Kaiser Permanente in Georgia seeks a skilled nurse reviewer to conduct medical necessity reviews for Home Care, DME, and Specialty Care referrals. The role involves telephonic assessments, eligibility checks, and coordinating with care teams to ensure appropriate resource use.

Required are RN licensure in Georgia and 3+ years of clinical nursing or Kaiser Nurse Residency completion. Strong knowledge of HIPAA and managed care regulations is essential.