- Community Health Systems (Franklin, TN)
- …in healthcare as a nurse required + 1-3 years work experience in Care Management or Utilization Review required + 1-2 years work experience as a ... **Job Summary** The Manager of Utilization Review oversees a team of...supports and coordinates the various aspects of the hospital's utilization management program, denials and appeals activities.… more
- Baylor Scott & White Health (Nashville, TN)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Humana (Nashville, TN)
- …independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review Post-Acute Preauth cases using ... caring community and help us put health first** The Utilization Management Nurse utilizes clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) compact license… more
- Ascension Health (Nashville, TN)
- …time of the offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review . + ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- The Cigna Group (Nashville, TN)
- The RN Coordinator serves as the key contact point for...as needed 3) 3+ years of experience as a Registered Nurse 4) Proficient level of experience with ... and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all...side effects, plan of care, and individualized care goals management in a culturally sensitive and acceptable manner for… more
- HCA Healthcare (Nashville, TN)
- …your next step in your career path, we encourage you to apply for our Case Management RN opening. We review all applications. Qualified candidates will be ... Do you have the career opportunities as a Case Management RN you want in your current...supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: +… more
- Vanderbilt University Medical Center (Nashville, TN)
- …operating and capital expenditure budgets; and performing personnel administration functions. The Registered Nurse Director for the Digestive Disease Center will ... Labs. Preferred Education, Skills, and Experiences: * Master's prepared Registered Nurse is essential * 5+ years...a proposed budget (operating and capital expenditure) to a management review committee. + Evaluate organizational functions… more
- Vanderbilt University Medical Center (Nashville, TN)
- …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... if additional records requests or actions might be indicated * Experience/proficiency in the review and the utilization of EPIC and/or eStar including the Media… more
- Highmark Health (Nashville, TN)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Lebanon Center for Rehabilitation and Healing (Lebanon, TN)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a...facility's Employee Handbook and as communicated by the facility's management . . Contributing to a positive work team by… more
- Baptist Memorial (Memphis, TN)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as ... prescribed by utilization review standards. The UR ...+ Employee referral program Job Summary: Position: 19737 - RN - Utilization Review Facility: BMHCC Corporate… more
- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) compact licensure… 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
- Covenant Health Inc. (Knoxville, TN)
- …Experience: Three to five (3-5) years of experience in a clinical setting, case management , or utilization review experience preferred. Must be computer ... + Monitors care processes to provide cost-effective implementation and evaluation of utilization management and patient care initiatives. + Maintains effective… more
- Covenant Health Inc. (Sevierville, TN)
- Overview Registered Nurse Care Manager, Continuum of Care PRN/OCC, Variable Hours, Day Shift LeConte Medical Center Overview: LeConte Medical Center is a part of ... services within the scope of practice as a registered nurse meeting all required standards both...in area of assigned responsibility. Licensure Requirement: Current Tennessee RN License. Current certification in Case Management ,… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Manager, Social Services PRN/OCC, Variable Hours & Shifts Fort Sanders Regional Medical Center is an award-winning, certified, and ... services within the scope of practice as a registered nurse meeting all required standards both...in area of assigned responsibility. Licensure Requirements: Current Tennessee RN License. Current certification in Case Management ,… more
- Covenant Health Inc. (Oak Ridge, TN)
- Overview Registered Nurse , Care Manager Full Time, 80 Hours Per Pay Period, Day Shift With more than 30 specialties from Cardiology and Neurosurgery to ... services within the scope of practice as a registered nurse meeting all required standards both...in area of assigned responsibility. Licensure Requirement: Current Tennessee RN License. Current certification in Case Management ,… more
- HCA Healthcare (Springfield, TN)
- …million dollars to charitable organizations. Apply Today! Job Summary and Qualifications The Registered Nurse ( RN ) CM is responsible for promoting ... We care like family! Jump-start your career as a ** RN PRN Case Management ** today with TriStar...supporting a balance of optimal care and appropriate resource utilization . **What you will do in this role** .… more
- Baptist Memorial (Memphis, TN)
- Summary May have administrative duties for risk management , utilization review , reimbursement, and oversight of all clinical patient care facilities with in ... increasing management and operations expertise. Licensure, Registration, Certification Minimum: RN About Baptist Memorial Health Care At Baptist, we owe our… more
- HCA Healthcare (Nashville, TN)
- …experience preferred + Certifications, Licenses, and other Special Requirements + Current/Active Registered Nurse ( RN ) License within practice state required ... Home Health RN Clinical Manager opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. **Unlock… more