- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Sharecare (Nashville, TN)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
- Veterans Affairs, Veterans Health Administration (Memphis, TN)
- …outcomes by collaborating with members of the interdisciplinary team. Responsibilities The Pain Management Registered Nurse ( RN ) identifies the patient's ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Vanderbilt University Medical Center (Nashville, TN)
- …through preeminent programs in patient care, education, and research. **Organization:** Utilization Management 10 **Job Summary:** JOB SUMMARY Facilitates ... instead of emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** Relevant… more
- Ascension Health (Nashville, TN)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours week. + **Hospital:** Ascension Saint Thomas + **Location:** ... TN market. We're looking for an experienced Director of Utilization Management to join our team! In...all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Tennessee Board… more
- Humana (Nashville, TN)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
- Highmark Health (Nashville, TN)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Community Health Systems (Franklin, TN)
- …Licenses:** Current RN license to practice in state **Preferred** + Utilization review and/or case management experience Equal Employment Opportunity This ... the essential functions. **Knowledge/Abilities** : **Required** + Understanding and utilization of medical necessity criteria for inpatient and outpatient services… more
- Guardian Life (Nashville, TN)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Highmark Health (Nashville, TN)
- … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
- Elevance Health (TN)
- **Be Part of an Extraordinary Team** ** Nurse Medical Management I** **Location:** Remote - Candidates must reside within 50 miles or 1-hour commute each way ... experience. **Preferred skills, qualifications and experiences:** + Prior experience in inpatient Utilization Management , preferred. + 3-5 years of experience in… more
- Covenant Health Inc. (Knoxville, TN)
- …+ Monitors care processes to provide cost-effective implementation and evaluation of utilization management and patient care initiatives. + Maintains effective ... Time, 80 Hours Per Pay Period, Day Shift Primarily Remote , some onsite clinic visits and meetings, equipment provided...(3-5) years of experience in a clinical setting, case management , or utilization review experience preferred. Must… more