• RN Utilization Management

    Humana (Nashville, TN)
    **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
    Humana (01/07/25)
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  • Registered Nurse - In Home Primary…

    The Cigna Group (Nashville, TN)
    The RN Coordinator serves as the key contact point for...as needed 3) 3+ years of experience as a Registered Nurse 4) Proficient level of experience with ... and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all...side effects, plan of care, and individualized care goals management in a culturally sensitive and acceptable manner for… more
    The Cigna Group (12/18/24)
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  • Case Management Registered

    HCA Healthcare (Nashville, TN)
    …your next step in your career path, we encourage you to apply for our Case Management RN opening. We review all applications. Qualified candidates will be ... Do you have the career opportunities as a Case Management RN you want in your current...supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: +… more
    HCA Healthcare (11/23/24)
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  • Registered Nurse Director…

    Vanderbilt University Medical Center (Nashville, TN)
    …operating and capital expenditure budgets; and performing personnel administration functions. The Registered Nurse Director for the Digestive Disease Center will ... Labs. Preferred Education, Skills, and Experiences: * Master's prepared Registered Nurse is essential * 5+ years...a proposed budget (operating and capital expenditure) to a management review committee. + Evaluate organizational functions… more
    Vanderbilt University Medical Center (11/13/24)
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  • Registered Nurse PRN (As Needed)…

    Vanderbilt University Medical Center (Nashville, TN)
    …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... if additional records requests or actions might be indicated * Experience/proficiency in the review and the utilization of EPIC and/or eStar including the Media… more
    Vanderbilt University Medical Center (12/27/24)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Nashville, TN)
    …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
    Highmark Health (01/07/25)
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  • Respiratory Registered Nurse

    Lebanon Center for Rehabilitation and Healing (Lebanon, TN)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a...facility's Employee Handbook and as communicated by the facility's management . . Contributing to a positive work team by… more
    Lebanon Center for Rehabilitation and Healing (12/19/24)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Nashville, TN)
    …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
    Highmark Health (12/12/24)
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  • Market Director of Utilization

    Ascension Health (Nashville, TN)
    **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours week. + **Hospital:** Ascension Saint Thomas + **Location:** ... TN market. We're looking for an experienced Director of Utilization Management to join our team! In...all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Tennessee Board… more
    Ascension Health (10/25/24)
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  • Utilization Management Behavioral…

    Humana (Nashville, TN)
    …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
    Humana (11/13/24)
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  • Director Regulatory Accreditation Nursing

    HCA Healthcare (Nashville, TN)
    …findings related to focused topics within HCA Healthcare Hospitals/ASCs including credentialing, utilization management , peer review , medical staff and board ... activity Preferred + Or equivalent combination of education and/or experience + Registered nurse , Engineer/Facilities, registered or accredited health… more
    HCA Healthcare (01/12/25)
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  • Case Management RN PRN

    HCA Healthcare (Springfield, TN)
    …million dollars to charitable organizations. Apply Today! Job Summary and Qualifications The Registered Nurse ( RN ) CM is responsible for promoting ... We care like family! Jump-start your career as a ** RN PRN Case Management ** today with TriStar...supporting a balance of optimal care and appropriate resource utilization . **What you will do in this role** .… more
    HCA Healthcare (12/29/24)
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  • Home Health RN Clinical Manager

    HCA Healthcare (Nashville, TN)
    …experience preferred + Certifications, Licenses, and other Special Requirements + Current/Active Registered Nurse ( RN ) License within practice state required ... Home Health RN Clinical Manager opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. **Unlock… more
    HCA Healthcare (01/13/25)
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  • RN MDS Director

    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 ... RN MDS Director Nashville Center for Rehabilitation and...by their supervisor and Administrator MDS Director Qualifications: + Registered Nurse with current, active license in… more
    Nashville Center for Rehabilitation and Healing (01/01/25)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Nashville, TN)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
    Guardian Life (12/20/24)
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  • Manager of Case Management

    Ascension Health (Nashville, TN)
    …specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and ... **Details** + **Department:** Case Management + **Schedule:** Full-Time, Exempt + **Hospital:** St...Registration: One or more of the following required: + Registered Nurse credentialed from the Tennessee Board… more
    Ascension Health (12/04/24)
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  • Associate Nursing Officer - Neuroscience

    Vanderbilt University Medical Center (Nashville, TN)
    …in embracing the change. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** ... The Associate Nursing Officer - Neuroscience shall provide general management for the operations of a Patient Care Center...or VUMC goals. * Promote and monitor the effective utilization of the assigned space in support of the… more
    Vanderbilt University Medical Center (01/03/25)
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  • Administrative Director Nursing- VHVI Region

    Vanderbilt University Medical Center (Nashville, TN)
    …in embracing the change. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** ... research, and patient care missions of the University's Medical Center. * Review , establish, and revise policies, procedures, and standards related to all aspects… more
    Vanderbilt University Medical Center (12/12/24)
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  • Consulting EHR Support Analyst

    HCA Healthcare (Hermitage, TN)
    …include: 1) implementation and support of division wide standardization, utilization , integration, and optimization activities related to advanced clinical ... resources. The Consulting EHR Support Analyst coordinates division-wide parameter management , develops education/training materials for new applications, manages validation… more
    HCA Healthcare (11/02/24)
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  • Clinical Resources Manager

    HCA Healthcare (Nashville, TN)
    …for Microsoft Word, Excel and PowerPoint preferred. + Demonstrated personal time management and project prioritization skills preferred. + LPN/ RN , Certified ... of supply expense opportunities to improve product standardization and utilization . This process includes product selection, evaluation and implementation of… more
    HCA Healthcare (01/11/25)
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