- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... appropriate additional documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if physicians are unable… more
- Community Health Systems (Franklin, TN)
- …necessity, both for admission to the hospital as well as continued stay. The Utilization Review Clinical Specialist supports and coordinates the various ... and extended hospital stays with portals, faxes and phone calls. The Utilization Review Clinical Specialist will monitor adherence to the hospital's … more
- HCA Healthcare (Smyrna, TN)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: + Provides case management ... appropriate and available to the patient/family. + Reassesses the patient's clinical condition as indicated. Considers patient's readmission status or risk of… more