- 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
- Community Health Systems (Franklin, TN)
- …medical necessity, both for admission to the hospital as well as continued stay. The Utilization Review Clinical Specialist supports and coordinates the ... admissions and extended hospital stays with portals, faxes and phone calls. The Utilization Review Clinical Specialist will monitor adherence to the… 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
- Elevance Health (Nashville, TN)
- …actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. **Minimum ... **Build the Possibilities. Make an Extraordinary Impact.** The **Medical Management Specialist I** is responsible for providing non- clinical support to… more
- Intermountain Health (Nashville, TN)
- …financially secure patients encounter(s) + Explains and answers patient, caregiver, provider, or clinical team questions when able + Denial review , appeal, and ... **Job Description:** The Pre-Access Prior Authorization RN provides timely review of authorization requests and/or review of...Nurse + Minimum of 2 years' experience in acute clinical nursing setting + Knowledge of utilization … more
- Prime Therapeutics (Nashville, TN)
- …and drives every decision we make. **Job Posting Title** Customer Care Specialist **Job Description** This position is a front-line service position providing ... into the appropriate delivery system to initiate the EAP, Care and Utilization management programs. + Demonstrates flexibility in areas such as job duties… 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 (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