- Community Health Systems (Franklin, TN)
- …works with the physicians on the medical staff hospital's to perform an internal secondary review . The UR Clinical Specialist may assist coordinating a Peer ... medical services and procedures in a Behavioral Health setting. Utilization review is the assessment for medical...the case management system by the UR Behavioral Health Review Specialist . + UR Clinical … more
- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... payer requirements. These discussions are to help the UR Clinical Specialist understand the reason for admission,...documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if… more
- HCA Healthcare (Nashville, TN)
- …personal growth, we encourage you to apply for our Clinical Pharmacist Specialist BMT Oncology PRN opening. We review all applications. Qualified candidates ... includes monitoring patient medication regimens and providing appropriate interventions. The Clinical Specialist shall also assist in mentoring pharmacy staff… more
- Houston Methodist (Nashville, TN)
- …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year ... ** Clinical Documentation Specialist - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** At Houston Methodist, the Clinical Documentation … more
- Vanderbilt University Medical Center (Nashville, TN)
- …monitoring plan to meet the individualized drug therapy needs of the patient. The clinical specialist is responsible for leading efforts in the prevention and ... of medication therapy. . KEY RESPONSIBILITIES * Coordinates the delivery of clinical pharmacy services in assigned areas (in concert with Operational Managers). *… more
- Community Health Systems (Franklin, TN)
- …and Licenses:** Current RN license to practice in state **Preferred** + Utilization review and/or case management experience Equal Employment Opportunity This ... level of care appeals using InterQual and CMS guidelines as needed. + Monitor clinical appeal processes for issues and trends and provide guidance and feedback to… more
- HCA Healthcare (Nashville, TN)
- …to clinicians regarding deficiencies or OASIS corrections (with feedback from Quality Review Specialist ) to ensure the medical records reflect compliance with ... medical necessity, homebound status, visit utilization , and documentation of individualized patient assessment and transition...encourage you to apply for our Home Health RN Clinical Manager opening. Our team will promptly review… more
- HCA Healthcare (Hermitage, TN)
- … utilization , integration, and optimization activities related to advanced clinical applications and tools in their specialty area(s), 2) development, execution, ... roles and core team members, and works with the Division EHR Support Specialist Team to ensure advanced clinical applications are well supported throughout… more
- HCA Healthcare (Hendersonville, TN)
- …and deliver hands-on training as needed, and to implement division standardization, utilization , integration and optimization plans for clinical applications. An ... Support Analyst II** , serves as a key onsite clinical IT resource for facility implementation and support of...facility. This individual works with the Division EHR Support Specialist Team and facility core team members to develop… 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 ... Clinical , Case Management and/or Condition Management + Experience in a clinical setting **Preferred** + Certification in utilization management or a related… more
- HCA Healthcare (Brentwood, TN)
- …support improved content, workflow analysis, optimization planning, and live support for clinical users of the EHR. **Supervisor:** Manager, EHR Service and Delivery ... in national user conferences to gain advanced knowledge of systems and customer utilization + Assists leads in developing clear and actionable product roadmaps for… more