- Evolent Health (Nashville, TN)
- …results, and collaborating with others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for assisting the ... UM Manager in supervising the operational productivity of the Utilization Management nurses by implementing and maintaining...flow of information through the UM department. The UM Lead , in collaboration with the UM Manager and Director,… more
- Elevance Health (Nashville, TN)
- ** RN Hospital Bill Audit/Appeal Lead ** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** RN Hospital Audit/Appeal Lead ** is responsible for leading a team… more
- Elevance Health (Nashville, TN)
- …**This is a field position 4-5 days per week** The **LTSS Service Coordinator - RN Clinician** is responsible for overall management of member's case within the ... scope of licensure; provides supervision and direction to non- RN clinicians participating in the member's case in accordance with applicable state law and contract;… more
- Vanderbilt University Medical Center (Nashville, TN)
- …in embracing the change. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** ... Lead activities related to performance, improvement, and risk management programs in order to establish and meet clinical...or VUMC goals. * Promote and monitor the effective utilization of the assigned space in support of the… more
- Vanderbilt University Medical Center (Nashville, TN)
- …in embracing the change. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** ... and revises programs of orientation, in-service-training, and continuing education. Takes a lead role in educational initiatives to ensure quality patient care and… more
- HCA Healthcare (Nashville, TN)
- …cohesive, iterative Change Strategy. + Report and escalate issues and risks to the Change Management lead as necessary. + **This job may require up to 50% ... environment where diversity and inclusion thrive? Submit your application for our Change Management Manager opening with HCA Healthcare today and find out what it… more
- Elevance Health (Nashville, TN)
- …- Clinician** this role will be working under the direction/supervision of an RN , with overall responsibility for the member's case, as required by applicable state ... **How you will make an impact:** + Assisting the responsible RN with telephonic or face-to-face assessments for the identification, evaluation, coordination… more
- HCA Healthcare (Nashville, TN)
- …through regular interaction, managing internal and external conflicts as necessary + Lead the effective identification and utilization of resources, networks, ... and coordination of all phases of complex IPS projects. This person will lead the development and execution of short/long term operational projects with key… more
- Elevance Health (Nashville, TN)
- …be required.** The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- HCA Healthcare (Nashville, TN)
- …management of Purchased Services; contract optimization, standardization and utilization of contracted Purchased Services categories; participates in development ... contract optimization, collaborating with the HealthTrust contracting team to lead strategic sourcing initiatives and contract negotiation as applicable. This… more