- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shifts Covenant Health Overview: Covenant Health is the region's ... management experience. Licensure Requirement: Current licensure as a Registered Nurse ( RN ) as issued...Management as evidenced by performance. Apply/Share Job Title RN UTILIZATION MGMT I ID… more
- Covenant Health Inc. (Morristown, TN)
- …throughout employment tenure. Apply/Share Job Title MGR QUALITY CARE MGMT ID 4348901 Facility Morristown-Hamblen Health System Department Name QUALITY MANAGEMENT ... Overview Mgr. Quality and Care Management , Quality Management Full Time, 80...their annual mammograms, biopsies, and can meet with a nurse navigator if needed. The Women's Center offers six… more
- Fresenius Medical Center (New Market, TN)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Lebanon, TN)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- CVS Health (Nashville, TN)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- Veterans Affairs, Veterans Health Administration (Johnson City, TN)
- …improvement process and initiatives as well as customer service programs. Responsibilities The Registered Nurse ( RN ) is responsible for providing competent, ... 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
- 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 )** in the… more
- Humana (Nashville, TN)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- Vanderbilt University Medical Center (Nashville, TN)
- …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... to impact pediatric patients and families from the beginning - Autonomy and Utilization of Critical Skills - Teamwork that displays comradery and family center care… more
- Lebanon Center for Rehabilitation and Healing (Lebanon, 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 ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions. +… more
- CVS Health (Nashville, TN)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued… more
- CenterWell (Nashville, TN)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- Covenant Health Inc. (Lenoir City, TN)
- Overview Registered Nurse Care Manager, Quality Management PRN/OCC,Hours and Shifts Vary Fort Loudoun Medical Center Overview: Fort Loudoun Medical Center is ... services within the scope of practice as a registered nurse meeting all required standards both...three (3) years of experience in area of assigned responsibility. RN with 1 year acute hospital case management… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Manager, Social Services PRN/OCC, Variable Hours and Shifts Fort Sanders Regional Overview: Fort Sanders Regional Medical Centeris ... certification bonuses, and leadership development programs. Position Summary: The RN Care Manager III is responsible for integrating evidenced... services within the scope of practice as a registered nurse meeting all required standards both… more
- HCA Healthcare (Nashville, TN)
- …Review, appeals, denials, managed care contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the state(s) of practice and/or ... invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical Nurse...Escalate medical review request and /or denial activities to management as needed. **What you will do in this… more
- Covenant Health Inc. (Harriman, TN)
- …+ Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory. + In ... of experience in area of assigned responsibility. Licensure Requirement: Current Tennessee RN License. Current certification in Case Management , CCM, ACM or… more
- Covenant Health Inc. (Harriman, TN)
- …+ Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory + In ... of experience in area of assigned responsibility. Licensure Requirement: Current Tennessee RN License. Current certification in Case Management , CCM, ACM or… more
- Gentiva (Knoxville, TN)
- …Executive Director to join our leadership team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care, ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- Community Health Systems (Clarksville, TN)
- Join us as a ** Registered Nurse ( RN ) - Charge Intensive Care Unit (ICU)** at Tennova Healthcare- Clarksville Unit: ICU 1+ years of ICU experience preferred ... Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient...addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse -… more