• Manager Care/Case Management

    CenterWell (Nashville, TN)
    …opportunities for managing populations and coordinating care to reduce acute and post - acute care utilization . The Manager role is hybrid with travel ... action plans that will reduce acute and post - acute care utilization . + Solicits/shares...management experience + Experience working in primary care, acute care, ambulatory care and or value-based care organizations… more
    CenterWell (01/21/25)
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  • Medical Director--Claims Management

    Humana (Nashville, TN)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services (such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (01/28/25)
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  • Medical Director - Gulf South

    Humana (Nashville, TN)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (12/03/24)
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  • Case Management RN

    HCA Healthcare (Nashville, TN)
    …facilitate a successful care transition. + Partners with Social Services to ensure the post - acute medical needs and level of care are appropriate. + Assumes ... Do you have the career opportunities as a Case Management RN you want in your current role? We...supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: +… more
    HCA Healthcare (01/25/25)
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  • Case Manager / PRN ( RN / RT / SW / LPN )

    Select Medical (Nashville, TN)
    … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...step-down, med surg, vents)** + Adequate experience in an acute medical case management setting and confidence… more
    Select Medical (01/29/25)
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  • Medical Director - Mid West Region

    Humana (Nashville, TN)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
    Humana (01/30/25)
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  • Manager Division Denials WFH

    HCA Healthcare (Nashville, TN)
    …confirm with NCBON. **Preferred Certification:** Nationally accepted certification in Case Management , Utilization Review, Coding, or other denial management ... in denial management . + Requires professional level of knowledge of utilization review, care management , InterQual and/or medical necessity methods, DRGs,… more
    HCA Healthcare (01/31/25)
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  • Director Clinical Pharmacy Member Support

    HCA Healthcare (Nashville, TN)
    …for leading, developing and implementing a Pharmacy Member Support strategic management plan for multiple non- acute /AdvantageTrust facilities. This position is ... alliances with key stakeholders as it relates to a successful pharmacy expense management program. **What you will do in this role includes:** Leadership +… more
    HCA Healthcare (01/23/25)
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  • Registered Nurse- In Home Primary…

    The Cigna Group (Nashville, TN)
    …and documents provided by health plan to prep weekly rounds of documentation ** Post - Acute Management and Coordination** 1. Participation in weekly care ... 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
    The Cigna Group (12/18/24)
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  • Physician Medical Director - LTSS

    Humana (Nashville, TN)
    …and interpretation skills with 5+ years of experience focusing on quality management , utilization management , discharge planning, rehabilitation services, ... attend Fair Hearings. The clinical scenarios arise from outpatient, post - acute care; acute inpatient; LTC...Clinical Integration, Long Term Services & Supports, and Case Management . The Medical Director, as indicated, could need to… more
    Humana (01/25/25)
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  • Advanced Practice Registered Nurse (APRN)

    Select Medical (Nashville, TN)
    …division of Select Medical, we care for chronically and critically ill or post -ICU patients who require extended hospital care. Select Medical employs over 48,000 ... with the multidisciplinary health care team, providing continuity in the care management of chronically critically ill patients. You will improve patient outcomes by… more
    Select Medical (01/25/25)
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  • Respiratory Registered Nurse

    Lebanon Center for Rehabilitation and Healing (Lebanon, TN)
    …can be for you. The position is within a Skilled Nursing facility. As a Post Acute and Long Term Care respiratory therapist, your role would involve providing ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions. +… more
    Lebanon Center for Rehabilitation and Healing (01/20/25)
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  • Executive Chef, Healthcare

    Compass Group, North America (Nashville, TN)
    …services. As specialists, we perform services including healthcare housekeeping, management in laundry processing, patient transportation, and food service. ... Thomas West. This is a 541 bed (average 350-387), acute care, Level II trauma hospital featuring bed side...is available when needed + Makes all decisions regarding utilization of leftover food products staying within Company guidelines… more
    Compass Group, North America (01/23/25)
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  • Registered Dietitian - Remote

    Sharecare (Nashville, TN)
    …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....in the orientation and to take the pre and post -test to review competency during orientation. Yearly competency test… more
    Sharecare (01/28/25)
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