- Kepro (Nashville, TN)
- …a vital partner for health solutions in the public sector. Acentra is looking for a Physician Medical Claims Reviewer to join our growing team. Job Summary: ... The primary responsibilities of a Physician Medical Claims Reviewer include...with guidelines. Job Responsibilities: + Prepare independent reviews of medical services appeals. + Review records, prepare… more
- Prime Therapeutics (Nashville, TN)
- …**Job Description Summary** Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the ... Initial Clinical Reviewers as needed to discuss cases and problems. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the MD… more
- Evolent Health (Nashville, TN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management ... **What You Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that...clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure… more
- Evolent Health (Nashville, TN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Physician Clinical Reviewer you will be a key member of the utilization ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. As well as,...within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure… more
- Evolent Health (Nashville, TN)
- …**Collaboration Opportunities:** + Routinely interacts with leadership and management staff, other Medical Directors, and health plan members and staff whenever a ... physician `s input is needed or required. Responsible for acting...patients as directed by the office of the Chief Medical Officer. **What You Will Be Doing:** + Responsible… more
- HCA Healthcare (Nashville, TN)
- …our goals. Unlock your potential! **Job Summary and Qualifications** The Clinical Review Specialist is responsible for performing retrospective medical reviews ... 156,000 hours volunteering in our communities. As a Clinical Reviewer with Parallon you can be a part of...In this role you will: + Perform a retrospective review of medical records using clinical expertise… more
- Highmark Health (Nashville, TN)
- …the APP, RN and SW as needed to interact/ communicate with the primary care physician as necessary for appropriate medical care. The role will provide oversight ... physician services by complementing the primary care physician , acting as a medical resource to...are followed in the program + Develop and continually review the education programs provided to the interdisciplinary team… more
- Elevance Health (Nashville, TN)
- …Operations Associate Medical Director** **Carelon Health** **Genetics Testing Utilization Review ** **Location** : The ideal candidate will live within 50 miles ... board certified specialty. + Makes physician to physician calls to gather medical appropriate information...decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director … more
- Houston Methodist (Nashville, TN)
- …accuracy and completeness of clinical information used for measuring and reporting physician and medical outcomes. **SERVICE ESSENTIAL FUNCTIONS** + Seeks ... of the clinical information used for measuring and reporting physician and hospital outcomes and educating all members of...acute care hospital setting is required; coding and utilization review experience preferred + For Medical School… more
- HCA Healthcare (Nashville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- HCA Healthcare (Nashville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... an exciting opportunity for you to join TriStar Centennial Medical Center which is part of the nation's leading...to apply for our Speech Language Pathologist opening. We review all applications. Qualified candidates will be contacted for… more
- HCA Healthcare (Nashville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... an exciting opportunity for you to join TriStar Skyline Medical Center which is part of the nation's leading...to apply for our Speech Language Pathologist opening. We review all applications. Qualified candidates will be contacted for… more
- HCA Healthcare (Hendersonville, TN)
- …patient communication. + You will consult with Program Director and Rehab Physician / Medical Director regarding pre-screen assessments and physician ... an exciting opportunity for you to join TriStar Hendersonville Medical Center which is part of the nation's leading...you to apply for our Speech Therapist opening. We review all applications. Qualified candidates will be contacted for… more
- ChenMed (Nashville, TN)
- …and in collaboration with other health care professionals. Consults with the manager, physician , and medical director to ensure compliance with guidelines. This ... population in collaboration and consultation with a licensed patient care team physician . Practices in accordance with a written or electronic practice agreement.… more
- Sutherland Global Services (Nashville, TN)
- Have you kept up with the changes in medical coding, physician practices, and the healthcare industry in general? Are you proficient with ICD-10, CPT and HCPCS ... with some of the country's largest healthcare systems and physician practices to help support their coding organizations in...in these efforts, we're looking for Multispecialty Pro Fee Medical Coders to join us on a **work from… more
- HCA Healthcare (Nashville, TN)
- …of privileges) and is responsible for facilitation and execution of physician notification processes regarding medical record documentation deficiency, ... as an HIM Director today with TriStar Southern Hills Medical Center. **Benefits** TriStar Southern Hills Medical ...records as needed. + Perform facility unbilled activities including physician query follow up, physician incomplete record… more
- HCA Healthcare (Nashville, TN)
- …of privileges) and assists with the facilitation and execution of physician notification processes regarding medical record documentation deficiency, delinquency ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Veterans Affairs, Veterans Health Administration (Nashville, TN)
- Summary The Primary Care Physician (Float) services as a practicing physician who is responsible for the overall management of patients enrolled for healthcare ... Care Team). Responsibilities VA offers a comprehensive total rewards package. VHA Physician Total Rewards. This position is eligible for the Education Debt Reduction… more
- HCA Healthcare (Nashville, TN)
- …and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...personal growth, we encourage you to apply for our Physician Compensation Coordinator opening. We promptly review … more
- Wolters Kluwer (Nashville, TN)
- …on clinical practice with our expert contributors. **ESSENTIAL DUTIES & RESPONSIBILITIES:** Our physician editors review and edit the new contributions from our ... the literature for new developments and identifying topics that need updating. Physician Editors also systematically review existing topics for clarity,… more