- CoreCivic (Brentwood, TN)
- …and a responsibility to better the public good. CoreCivic is currently seeking a ** Utilization Management / Case Management Nurse** located at our ... onsite and 2 days remote out of our Brentwood, TN office location._ The Utilization Management / Case Management Nurse provides Utilization Review and … more
- Humana (Nashville, TN)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Nashville, TN)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Nashville, TN)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Community Health Systems (Franklin, TN)
- …clinics, imaging centers, cancer centers and ambulatory surgery centers. **Summary:** Utilization management is the analysis of the necessity, appropriateness, ... of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both...care. + Documents all actions and activities in the case management software system used by the… more
- Community Health Systems (Franklin, TN)
- …clinics, imaging centers, cancer centers and ambulatory surgery centers. **Summary:** Utilization management is the analysis of the necessity, appropriateness, ... medical services and procedures in a Behavioral Health setting. Utilization review is the assessment for medical necessity, both...care. + Documents all actions and activities in the case management software system used by the… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Director Case Management ? At TriStar Centennial Medical Center, you come first. HCA Healthcare has ... a difference. We are looking for a dedicated Director Case Management like you to be a...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of… more
- United Therapeutics (Nashville, TN)
- …pulmonary diseases, and other orphan diseases. **How you'll contribute** The Associate Global PV Case Management Director plays a key role in management and ... processing for commercial UT products, including PM GSD workflows; Maintain unified PM Case Management operating procedures and monitor systems to ensure all PM… more
- Ascension Health (Nashville, TN)
- …in the areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revises assignments ... **Details** + **Department:** Case Management + **Schedule:** Full-Time, Exempt + **Hospital:** St Thomas West + **Location:** Nashville, TN **Benefits** Paid… more
- HCA Healthcare (Nashville, TN)
- …Bonus available for qualified RN candidates! Do you have the career opportunities as a Case Management RN you want in your current role? We invest in what ... supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: +...What you will do in this role: + Provides case management services for both inpatient and… more
- HCA Healthcare (Nashville, TN)
- …resource utilization . What you will do in this role: + Provides case management services for both inpatient and observation patients as assigned. + ... + Makes appropriate referrals to third party payer and disease and case management programs for recurring patients and patients with chronic disease states. +… more
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... documentation. You will report directly to the Director of Case Management and provide social work services,...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Metro Nashville Government (Nashville, TN)
- …non-Civil Service position in the Office of Family Safety, and will provide full Case Management services to Family Safety Center (FSC) and/or Jean Crowe ... + References + Answer the supplemental questions Typical Duties + Provide case management services for victims of interpersonal violence (domestic violence,… more
- Vanderbilt University Medical Center (Lebanon, TN)
- …through preeminent programs in patient care, education, and research. **Organization:** Case Management **Job Summary:** Discover Vanderbilt University Medical ... care and in balancing quality patient care with cost-effective utilization of resources. . This is a PRN position...with peers and other clinical team members independently. * Case Management (Intermediate): Demonstrates mastery of … more
- Travelers Insurance Company (Nashville, TN)
- …also needed. + Drive the information advantage including data integrity, use of management information and utilization of technology and tools. + Exhibit ... not result in presenting on said losses to senior management in Claim and Business Insurance Partners. + Co-adjusts...equipment as needed. + Collaborates with other Boiler Major Case adjusters on technical issues and coverage to leverage… more
- Sunrun (Nashville, TN)
- …+ Own and develop partner or branch relationships including weekly/monthly reviews, utilization and workload management , process updates and identification and ... through our commitment to diversity, inclusion and belonging. **Overview** The O&M Case Manager is responsible for coordinating effective execution of field service… more
- Community Health Systems (Franklin, TN)
- …documentation from the physician(s). + Documents all actions and activities related to utilization review in the case management software system used ... **Job Summary** Utilization management is the analysis of...social workers, discharge planners, etc.) virtually, and/or through the case management software to ensure effective collaboration… more
- Highmark Health (Nashville, TN)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... , identification of opportunities for referral to a Health Coach/ case management , and identification and resolution of...Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +… more
- CenterWell (Murfreesboro, TN)
- …performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. ... the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including… more
- Highmark Health (Nashville, TN)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... , identification of opportunities for referral to a Health Coach/ case management , and identification and resolution of...clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS**… more