- Kepro (Nashville, TN)
- …a vital partner for health solutions in the public sector. Acentra is looking for a Physician Medical Claims Reviewer to join our growing team. Job Summary: ... The primary responsibilities of a Physician Medical Claims Reviewer include...with guidelines. Job Responsibilities: + Prepare independent reviews of medical services appeals. + Review records, prepare… more
- Veterans Affairs, Veterans Health Administration (Nashville, TN)
- Summary Position entails a combined physician appointment in the Medical Imaging section of the VA Tennessee Valley Healthcare System (TVHS) at both the ... in a timely manner on all critical findings. The physician will participate in peer review activity...radiology residents and medical students from affiliated medical schools. b. The physician will perform… more
- Prime Therapeutics (Nashville, TN)
- …**Job Description Summary** Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the ... Initial Clinical Reviewers as needed to discuss cases and problems. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the MD… more
- Evolent Health (Nashville, TN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management ... **What You Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that...clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure… more
- Evolent Health (Nashville, TN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Oncology, Physician Clinical Reviewer you will be a key member of the utilization ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. As well as,...within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure… more
- Prime Therapeutics (Nashville, TN)
- …development of medical pharmacy solutions programs. Supports drug utilization review (DUR) efforts by reviewing physician prescribing patterns, consulting ... fuels our passion and drives every decision we make. **Job Posting Title** Hemophilia Clinical Reviewer (ICR) **Job Description Summary** Facilitates efforts in the… more
- Highmark Health (Nashville, TN)
- …I. GENERAL OVERVIEW: * Receive, review and make determinations regarding physician reviewer assignments for medical management decisions. Cases requiring ... review are provider and member requests, received from Medical Management & Policy (MM&P) and Member Grievance Departments....receipt, review and assignment of all incoming physician reviewer referrals and appeals to ensure… more
- Highmark Health (Nashville, TN)
- …the APP, RN and SW as needed to interact/ communicate with the primary care physician as necessary for appropriate medical care. The role will provide oversight ... physician services by complementing the primary care physician , acting as a medical resource to...are followed in the program + Develop and continually review the education programs provided to the interdisciplinary team… more
- Houston Methodist (Nashville, TN)
- …accuracy and completeness of clinical information used for measuring and reporting physician and medical outcomes. **SERVICE ESSENTIAL FUNCTIONS** + Seeks ... of the clinical information used for measuring and reporting physician and hospital outcomes and educating all members of...acute care hospital setting is required; coding and utilization review experience preferred + For Medical School… more
- HCA Healthcare (Nashville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- HCA Healthcare (Nashville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... an exciting opportunity for you to join TriStar Centennial Medical Center which is part of the nation's leading...to apply for our Speech Language Pathologist opening. We review all applications. Qualified candidates will be contacted for… more
- HCA Healthcare (Nashville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... an exciting opportunity for you to join TriStar Skyline Medical Center which is part of the nation's leading...to apply for our Speech Language Pathologist opening. We review all applications. Qualified candidates will be contacted for… more
- HCA Healthcare (Hendersonville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... an exciting opportunity for you to join TriStar Hendersonville Medical Center which is part of the nation's leading...you to apply for our Speech Therapist opening. We review all applications. Qualified candidates will be contacted for… more
- ChenMed (Nashville, TN)
- …and in collaboration with other health care professionals. Consults with the manager, physician , and medical director to ensure compliance with guidelines. This ... population in collaboration and consultation with a licensed patient care team physician . Practices in accordance with a written or electronic practice agreement.… more
- Sutherland Global Services (Nashville, TN)
- Have you kept up with the changes in medical coding, physician practices, and the healthcare industry in general? Are you proficient with ICD-10, CPT and HCPCS ... with some of the country's largest healthcare systems and physician practices to help support their coding organizations in...in these efforts, we're looking for Multispecialty Pro Fee Medical Coders to join us on a **work from… more
- HCA Healthcare (Nashville, TN)
- …of privileges) and is responsible for facilitation and execution of physician notification processes regarding medical record documentation deficiency, ... as an HIM Director today with TriStar Southern Hills Medical Center. **Benefits** TriStar Southern Hills Medical ...records as needed. + Perform facility unbilled activities including physician query follow up, physician incomplete record… more
- HCA Healthcare (Nashville, TN)
- …of privileges) and assists with the facilitation and execution of physician notification processes regarding medical record documentation deficiency, delinquency ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Veterans Affairs, Veterans Health Administration (Nashville, TN)
- Summary The Primary Care Physician (Float) services as a practicing physician who is responsible for the overall management of patients enrolled for healthcare ... Care Team). Responsibilities VA offers a comprehensive total rewards package. VHA Physician Total Rewards. This position is eligible for the Education Debt Reduction… more
- HCA Healthcare (Nashville, TN)
- …and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...personal growth, we encourage you to apply for our Physician Compensation Coordinator opening. We promptly review … more
- Vanderbilt University Medical Center (Nashville, TN)
- **Discover Vanderbilt University Medical Center:** Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, ... 22 weeks through 2 years old. + Neonatal Nurse Practitioner + or + Physician Assistant (NICU Experience or NICU APP Fellowship Required) **_$15,000 Sign On Bonus for… more