- Humana (Nashville, TN)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- Cognizant (Nashville, TN)
- …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical … more
- Evolent (Nashville, TN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- Schedule . 5 days a week 37.5 - 40 hours per week Respiratory Nurse (RN) We are searching for a highly motivated, flexible, organized, skilled respiratory therapist ... patient needs and uses current treatment knowledge in accordance with facilities clinical procedures. This includes but is not limited to: . Performing accurate,… more
- Evolent (Nashville, TN)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... accomplishments. **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- CVS Health (Nashville, TN)
- …health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care, ... education, connecting members to resources, and facilitating referrals to care management programs for continued support. This position supports the development and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …to impact pediatric patients and families from the beginning - Autonomy and Utilization of Critical Skills - Teamwork that displays comradery and family center care ... * Analyzes comprehensive information pertinent to the patient's care and management to determine nursing diagnosis. * Continually utilizes the nursing process… more
- Deloitte (Nashville, TN)
- … registered nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG ... and informal education of physicians, CDI team, health information management and other clinical staff + Develop...medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical … more
- Philips (Nashville, TN)
- …etc) with clinical experience as Radiologic Technologist (RT) or Registered Nurse (RN) highly preferred. + Experience in healthcare (in the hospital) within ... **Sales Support, Clinical Specialist - FORS (West/National Travel)** In this...to effectively manage assigned accounts in terms of driving utilization , customer relationship management , problem resolution, etc.… more
- HCA Healthcare (Nashville, TN)
- …hospital departments and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of ... in Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse (RN) licensure , Licensed Clinical Social Worker (LCSW) or… more
- Adecco US, Inc. (Nashville, TN)
- …interdisciplinary teams and external partners to promote continuity of care, optimize clinical resource utilization , and achieve key performance outcomes. This ... **Case Management Director** **Position Title:** Director of Case ...licensure as one of the following required: + Registered Nurse (RN) + Licensed Clinical Social Worker… more
- Select Medical (Nashville, TN)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... **Case Manager (PRN)** _Requires a current licensure in a clinical discipline either as a Nurse or...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Select Medical (Nashville, TN)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... **Case Manager (PRN)** _Requires a current licensure in a clinical discipline either as a Nurse or...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- HCA Healthcare (Nashville, TN)
- …their division to improve the nursing practice of the organization through clinical education and competency management + Consistently seeks improvement ... area. This includes educational aspects of orientation and onboarding of clinical employees, clinical professional development, and development of education… more
- Trevecca Center for Rehabilitation and Healing (Nashville, TN)
- …communication skills. Knowledge of respiratory community. Demonstrated leadership and management skills. Skills applicable to clinical discipline. Knowledge ... the following departmental operations: Compliance with facility's policies, procedures, clinical standards, and protocols. Compliance to documentation guidelines and… more
- HCA Healthcare (Nashville, TN)
- …required (LPC, LMFT, LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with required DSM V-R ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...assessment completed and physician consult. + Provides a thorough clinical review and risk assessment with appropriate level of… more
- Oracle (Nashville, TN)
- …of analysts providing support for operationally required changes and enhancements to clinical applications, and aa group of analysts leading projects that will ... These include, but are not limited to, multiple Essential Clinical Dataset (ECD) alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding,… more
- Gentiva (Springfield, TN)
- …Nurse (RN) with strong leadership experience in hospice care, home health, or clinical operations management . If you're a natural leader who is passionate ... about patient-centered care, team development, and clinical excellence, we invite you to bring your talent...while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain… more
- Vanderbilt University Medical Center (Nashville, TN)
- …(APPs). This high-impact role oversees a talented group of approximately 18 Nurse Practitioners and Physician Assistants who deliver exceptional care to both ... Tennessee. As Manager, you'll play a pivotal role in optimizing clinical operations-driving performance metrics such as patient volume, schedule utilization… more
- Community Health Systems (Clarksville, TN)
- …huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate ... are available and properly utilized while maintaining cost-effective resource management . + Facilitates ongoing education and professional development for nursing… more