- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- Humana (Nashville, TN)
- …work hours and hard-wired, high-speed internet service is required for this position --_ The Utilization Management Nurse 2 helps to ensure fully ... and hard-wired, high-speed internet service is required for this position --_** The Utilization Management Nurse 2 helps to ensure fully coordinated care… more
- Elevance Health (Nashville, TN)
- ** Nurse Audit Lead** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… more
- Elevance Health (Nashville, TN)
- **Telephonic Nurse Disease Management II** **$2000 Sign on...Monday - Friday 12:30 pm - 9 pm, or 2 :30 pm - 11 pm EST.** The **Telephonic** **N** **urse ... Disease Management II** will be responsible for telephonic outreach, enrollment,...for multiple managed conditions to ensure cost-effective and efficient utilization of health services. Conducts assessment, planning, implementation, coordination,… more
- Nashville Center for Rehabilitation and Healing (Nashville, TN)
- …and ensures that appropriate follow-up action is taken + Facilitates the Care Management Process engaging the resident, IDT and family in timely identification and ... basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates...directed by their supervisor and Administrator Qualifications: + Registered Nurse / LPN with current, active license in state… more
- HCA Healthcare (Nashville, TN)
- …experience with 2 years critical care or 3 years nursing experience with 2 years case management experience preferred. 3. Certification in case management ... make a real impact with your work? With over 2 ,000 sites of care and serving over 31. 2...opportunity to make a real impact. As a(an) Case Management RN you can be a part of change.… more
- HCA Healthcare (Nashville, TN)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . . Provides case management services for both inpatient and ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...Nursing Diploma Required * Bachelor's Degree in Nursing Preferred 2 + years experience in case management OR… more
- HCA Healthcare (Nashville, TN)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . Provides case management services for both inpatient and ... continue to learn! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care...in Nursing or Nursing Diploma Bachelor's Degree in Nursing 2 + years experience in case management OR… more
- Rep-Lite (Nashville, TN)
- …providing comprehensive education and support to healthcare professionals on the utilization of cutting-edge medical devices across various healthcare settings, with ... and hospital staff to ensure seamless integration and optimal utilization of medical devices. + Identify customer needs and...ABILITIES: + Bachelor of Science in Nursing (BSN), Registered Nurse (RN), Physician Assistant (PA), or Nurse … more
- HCA Healthcare (Nashville, TN)
- …of nursing experience required + 2 - 4 years of relevant case management / utilization review experience required + Registered Nurse - Currently licensed ... position will provide front-line support and supervision to the Utilization Review staff to focus on initial and continued...required + InterQual Certification- IQCI or CER preferred + 2 + years of experience in InterQual preferred HCA Healthcare… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- …multiple levels of risk\. **Job Description:** **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases ... mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits + Performing the essential activities of case … more
- The Cigna Group (Franklin, TN)
- … and Coordination** 1. Participation in weekly care coordination with health plan case management as directed by market needs 2 . Referral Management Care ... in regard to their appointments, care, and overall health. 2 . Act as the liaison between the providers and...side effects, plan of care, and individualized care goals management in a culturally sensitive and acceptable manner for… more
- Wellpath (Nashville, TN)
- …**How you make a difference** The Workers' Compensation Specialist oversees the management of workers' compensation claims and collaborates with adjusters, nurse ... and claim adjudication, while working with various parties such as adjusters, nurse case managers, defense counsel, HR, and testimony. + Evaluates claims based… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- …and maximize therapist efficiency. Managing Medicare Medical Review and Denials Management process in conjunction with the Regional CareRite denials support and ... therapy staff. 2 . Monitors financial performance of rehab department and effectively...in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers… more
- Green Hills Center for Rehabilitation and Healing (Nashville, TN)
- …of computerized systems to optimize data quality and maximize therapist efficiency. 2 . Monitors the financial performance of the Respiratory Therapy department and ... outlined in the facility's Employee Handbook and as communicated by the facility's management . + Contributing to a positive work team by sharing information, using… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Board of Nursing standards. Three great reasons to join us: - Autonomy and Utilization of Critical Skills - Teamwork that displays comradery and family center care - ... we serve. Sign On Terms: - $25,000 (taxable) over 2 years - The sign-on bonus is not applicable...Analyzes comprehensive information pertinent to the patient's care and management to determine nursing diagnosis. * Continually utilizes the… more