- Humana (Nashville, TN)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Lincoln Financial Group (Nashville, TN)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Humana (Nashville, TN)
- …and ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- Humana (Nashville, TN)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
- ChenMed (Nashville, TN)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... **Job Requirements** The Nurse Practitioner must demonstrate the ability to function...management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards… more
- The Cigna Group (Nashville, TN)
- …at home to improve quality of life, increase understanding and management of serious illness, facilitate coordination between providers, and decrease unnecessary ... includes health risk assessments, transitions of care, complex and chronic disease management , and palliative care support. We conduct in-home longitudinal care for… more
- HCA Healthcare (Smyrna, TN)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . . provides case management services for both inpatient and ... compassion and comfort in our modern facility. The Registered Nurse (RN) CM is responsible for promoting patient-centered care...path, we encourage you to apply for our Case Management RN PRN opening. We review all… more
- LifePoint Health (Gallatin, TN)
- … management program. Ensure staff competencies in all areas of care management to include utilization review , transition/discharge planning, social work ... current upon hire *Required Skills* Licenses: State of Tennessee or Multi-State Registered Nurse licensure - Required Certification in Case Management such as… 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 ... continue to learn! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care...you, we encourage you to apply for our Case Management RN opening. Our team will promptly review… 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 ... Centennial Medical Center! **Job Summary and Qualifications** The Registered Nurse (RN) CM is responsible for promoting patient-centered care...path, we encourage you to apply for our Case Management RN PRN opening. We review all… more
- Elevance Health (Nashville, TN)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... Level:** Non- Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation… more
- Vanderbilt University Medical Center (Nashville, TN)
- …- Neuroscience. The Associate Nursing Officer - Neuroscience shall provide general management for the operations of a Patient Care Center by providing administrative ... * Lead activities related to performance, improvement, and risk management programs in order to establish and meet clinical...or VUMC goals. * Promote and monitor the effective utilization of the assigned space in support of the… more
- Vanderbilt University Medical Center (Nashville, TN)
- …research, and patient care missions of the University's Medical Center. * Review , establish, and revise policies, procedures, and standards related to all aspects ... Create programs to meet the future market requirements. * Monitor and review departmental performance of productivity targets. * Implement changes for improvement… more
- HCA Healthcare (Hendersonville, TN)
- …effective labor management , including position control, scheduling excellence, productivity management , and premium pay utilization to maintain staffing to ... + Bachelor's Degree required, Master's Degree preferred + Current licensure as a Registered Nurse (RN) in the state of practice required + 1-3 years of related… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- …to optimize data quality and maximize therapist efficiency. Managing Medicare Medical Review and Denials Management process in conjunction with the Regional ... of Rehabilitation in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers to achieve budget… more
- The Cigna Group (Franklin, TN)
- …about their care options and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all requirements 5. Explain test ... education including possible side effects, plan of care, and individualized care goals management in a culturally sensitive and acceptable manner for the patient or… more
- Cardinal Health (Nashville, TN)
- …for physician leaders and physician board regarding all areas of practice management and operations. This leader has primary responsibility to manage and drive ... will be needed in the following areas: practice operations, revenue cycle management , patient growth and practice marketing, value-based care, payor relations, EHR,… more
- HCA Healthcare (Nashville, TN)
- …and performance of assigned home health care team(s) Supervises ongoing case management of all patients ensuring an accurate evaluation and treatment plan, ... clinicians regarding deficiencies or OASIS corrections (with feedback from Quality Review Specialist) to ensure the medical records reflect compliance with medical… more
- Nashville Center for Rehabilitation and Healing (Nashville, TN)
- …trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends ... and ensures that appropriate follow-up action is taken + Facilitates the Care Management Process engaging the resident, IDT and family in timely identification and… more