• Post - Acute Utilization

    Humana (Nashville, TN)
    …require interpretation and independent determination of the appropriate courses of action. The Post - Acute Utilization Management Nurse 2: + Review ... caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills...1 or more years previous clinical experience in a Post - Acute clinical setting such as a SNF,… more
    Humana (01/25/25)
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  • Medical Director--Claims Management

    Humana (Nashville, TN)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services (such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (10/29/24)
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  • Manager, Care Integration Team

    CenterWell (Nashville, TN)
    …opportunities for managing populations and coordinating care to reduce acute and post - acute care utilization . The Manager role is hybrid with travel ... action plans that will reduce acute and post - acute care utilization . + Solicits/shares...management experience + Experience working in primary care, acute care, ambulatory care and or value-based care organizations… more
    CenterWell (01/21/25)
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  • Case Management RN PRN

    HCA Healthcare (Springfield, TN)
    …facilitate a successful care transition. . Partners with Social Services to ensure the post - acute medical needs and level of care are appropriate. . Assumes ... family! Jump-start your career as a **RN PRN Case Management ** today with TriStar NorthCrest Medical Center. Benefits TriStar...supporting a balance of optimal care and appropriate resource utilization . **What you will do in this role** .… more
    HCA Healthcare (12/29/24)
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  • Medical Director - Gulf South

    Humana (Nashville, TN)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (12/03/24)
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  • Case Management RN

    HCA Healthcare (Nashville, TN)
    …facilitate a successful care transition. + Partners with Social Services to ensure the post - acute medical needs and level of care are appropriate. + Assumes ... Do you have the career opportunities as a Case Management RN you want in your current role? We...supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: +… more
    HCA Healthcare (01/25/25)
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  • Manager of Case Management

    Ascension Health (Nashville, TN)
    …associates who work in case management , as well as tracking of the post - acute period and provision of disease management , and contracting with internal ... **Details** + **Department:** Case Management + **Schedule:** Full-Time, Exempt + **Hospital:** St...utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revises… more
    Ascension Health (12/04/24)
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  • Case Management RN PRN

    HCA Healthcare (Nashville, TN)
    …facilitate a successful care transition. + Partners with Social Services to ensure the post - acute medical needs and level of care are appropriate. + Assumes ... stay, managing the length of stay, ensuring appropriate resource management and developing a safe appropriate discharge plan in...supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: +… more
    HCA Healthcare (11/19/24)
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  • Case Manager / PRN ( RN / RT / SW / LPN )

    Select Medical (Nashville, TN)
    … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...step-down, med surg, vents)** + Adequate experience in an acute medical case management setting and confidence… more
    Select Medical (12/06/24)
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  • Medical Director - Mid West Region

    Humana (Nashville, TN)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (10/29/24)
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  • Mgr CDI

    Covenant Health Inc. (Knoxville, TN)
    …links with Integrity Office, Coding/Transcription, Quality Management , Case Management , Utilization Management , Physician Advisors and KBOS. ... feedback on program objectives. + Works closely with KBOS, RAC Physician Advisors, Utilization Management , Quality Management and Coding personnel to assure… more
    Covenant Health Inc. (12/14/24)
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  • Director of Payment Innovations

    Community Health Systems (Franklin, TN)
    …opportunities to improve performance to improve quality of patient care and reduce unnecessary post - acute care utilization . The Director will be able to ... delivery and reimbursement in multiple healthcare settings including, for example, ambulatory, acute hospitals, post - acute facilities and homecare + Relevant… more
    Community Health Systems (01/22/25)
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  • System Director-Quality

    Baptist Memorial (Memphis, TN)
    …of best evidence-based practices in inpatient, outpatient, ambulatory, and post - acute settings, when appropriate.Facilitates change through the implementation ... interventions to drive improved patient outcomes and healthcare delivery efficiency in acute care, outpatient, ambulatory, and post - acute care settings.… more
    Baptist Memorial (01/23/25)
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  • Director Clinical Pharmacy Member Support

    HCA Healthcare (Nashville, TN)
    …for leading, developing and implementing a Pharmacy Member Support strategic management plan for multiple non- acute /AdvantageTrust facilities. This position is ... alliances with key stakeholders as it relates to a successful pharmacy expense management program. **What you will do in this role includes:** Leadership +… more
    HCA Healthcare (01/23/25)
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  • Registered Nurse- In Home Primary…

    The Cigna Group (Nashville, TN)
    …and documents provided by health plan to prep weekly rounds of documentation ** Post - Acute Management and Coordination** 1. Participation in weekly care ... education including possible side effects, plan of care, and individualized care goals management in a culturally sensitive and acceptable manner for the patient or… more
    The Cigna Group (12/18/24)
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  • National Medicaid Medial Director - Long Term…

    Humana (Nashville, TN)
    …and interpretation skills with 5+ years of experience focusing on quality management , utilization management , discharge planning, rehabilitation services, ... attend Fair Hearings. The clinical scenarios arise from outpatient, post - acute care; acute inpatient; LTC...Clinical Integration, Long Term Services & Supports, and Case Management . The Medical Director, as indicated, could need to… more
    Humana (01/25/25)
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  • Analyst, Business Systems HIM - Remote

    LifePoint Health (Brentwood, TN)
    …of deployment for all types, including but not limited to, Joint Venture (JV), Post - Acute , Acute , etc. * Maintain strong role and work collaboratively ... departments by planning, supporting, and implementing information systems for Health Information Management . The Analyst - Business Systems acts as a liaison between… more
    LifePoint Health (12/30/24)
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  • Advanced Practice Registered Nurse (APRN)

    Select Medical (Nashville, TN)
    …division of Select Medical, we care for chronically and critically ill or post -ICU patients who require extended hospital care. Select Medical employs over 48,000 ... with the multidisciplinary health care team, providing continuity in the care management of chronically critically ill patients. You will improve patient outcomes by… more
    Select Medical (01/25/25)
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  • RN-Nurse Practitioner - MG Memphis Stroke Service

    Baptist Memorial (Memphis, TN)
    …inpatient Stroke Neurology team at BMH. In this role the APP will treat acute ischemic and hemorrhagic strokes. Will coordinate code strokes, in real-time with the ... physicians, for all patients with acute stroke symptoms and determine eligibility for alteplase treatment...the Vascular Neurologists to treat problems in the immediate post -stroke phase for patients in the ICU, step-down unit,… more
    Baptist Memorial (11/20/24)
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  • Respiratory Registered Nurse

    Lebanon Center for Rehabilitation and Healing (Lebanon, TN)
    …can be for you. The position is within a Skilled Nursing facility. As a Post Acute and Long Term Care respiratory therapist, your role would involve providing ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions. +… more
    Lebanon Center for Rehabilitation and Healing (01/20/25)
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