• PRN Utilization Review

    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 ... payer requirements. These discussions are to help the UR Clinical Specialist understand the reason for admission,...documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if… more
    Community Health Systems (01/19/25)
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  • PRN UR Clinical Specialist (Remote)

    Community Health Systems (Franklin, TN)
    …medical necessity, both for admission to the hospital as well as continued stay. The Utilization Review Clinical Specialist supports and coordinates the ... admissions and extended hospital stays with portals, faxes and phone calls. The Utilization Review Clinical Specialist will monitor adherence to the… more
    Community Health Systems (01/16/25)
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  • Clinical Pharmacist Specialist BMT…

    HCA Healthcare (Nashville, TN)
    …personal growth, we encourage you to apply for our Clinical Pharmacist Specialist BMT Oncology PRN opening. We review all applications. Qualified candidates ... includes monitoring patient medication regimens and providing appropriate interventions. The Clinical Specialist shall also assist in mentoring pharmacy staff… more
    HCA Healthcare (01/08/25)
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  • Clinical Documentation Specialist

    Houston Methodist (Nashville, TN)
    …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year ... ** Clinical Documentation Specialist - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** At Houston Methodist, the Clinical Documentation … more
    Houston Methodist (12/03/24)
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  • Medical Management Specialist I

    Elevance Health (Nashville, TN)
    …actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. **Minimum ... **Build the Possibilities. Make an Extraordinary Impact.** The **Medical Management Specialist I** is responsible for providing non- clinical support to… more
    Elevance Health (01/22/25)
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  • Field Reimbursement Specialist

    Amgen (Nashville, TN)
    …and transform the lives of patients while transforming your career. **Field Reimbursement Specialist - Nashville, TN** **What you will do** Let's do this. Let's ... change the world. In this vital role the Field Reimbursement Specialist (FRS) will manage defined accounts within a specified geographic region for Patient Access… more
    Amgen (01/26/25)
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  • Home Health RN Clinical Manager

    HCA Healthcare (Nashville, TN)
    …to clinicians regarding deficiencies or OASIS corrections (with feedback from Quality Review Specialist ) to ensure the medical records reflect compliance with ... medical necessity, homebound status, visit utilization , and documentation of individualized patient assessment and transition...encourage you to apply for our Home Health RN Clinical Manager opening. Our team will promptly review more
    HCA Healthcare (01/13/25)
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  • Consulting Product Analyst SQL eCW

    HCA Healthcare (Brentwood, TN)
    …support improved content, workflow analysis, optimization planning, and live support for clinical users of the EHR. **Supervisor:** Manager, EHR Service and Delivery ... in national user conferences to gain advanced knowledge of systems and customer utilization + Assists leads in developing clear and actionable product roadmaps for… more
    HCA Healthcare (12/20/24)
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