- Community Health Systems (Franklin, TN)
- …experience + Preferred Experience: 3 plus years Utilization review experience + Required License/Registration/Certification: Licensed Practical Nurse or ... efficiency of medical services and procedures in a Behavioral Health setting. Utilization review is the assessment for medical necessity, both for admission to… 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
- Baylor Scott & White Health (Nashville, TN)
- …vary based on position type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff. You oversee care coordination across ... Factors** + Demonstrable knowledge in discharge planning, case management, utilization review and different care levels. +...work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse 2...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Ascension Health (Nashville, TN)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40...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. + ... and external customers and stakeholders. **Preferred Qualifications** + Experience with utilization review process. + Experience with behavioral change, health… 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 ... . 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… more
- CenterWell (Murfreesboro, TN)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Vanderbilt University Medical Center (Nashville, TN)
- …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... requests or actions might be indicated * Experience/proficiency in the review and the utilization of EPIC and/or eStar including the Media tab, Care Everywhere,… more
- Baptist Memorial (Memphis, TN)
- …and/or life situation. Performs other duties as assigned. Responsibilities + Utilization Review + Discharge planning + Readmission Reduction Participation ... Facility: BMH - Memphis Hospital Department: ME Case Management Admin Baptist Memphis Category: Nurse RN Type: Non Clinical Work Type: Full Time Work Schedule:… 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
- 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...of the team to manage heath care cost and utilization **Provider Support** 1. Completes telephonic nursing assessments including… 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 ... Oaks (OHO) Endoscopy Labs. Preferred Education, Skills, and Experiences: * Master's prepared Registered Nurse is essential * 5+ years of leadership experience in… more
- Baptist Memorial (Memphis, TN)
- Summary Manages the resources for utilization review and case management to achieve the organizational goals. Has direct supervisory accountability for ... delivery of patient care related to case management and utilization review . * Supervises daily operations, activities,...required. * Bachelor's degree or higher degree preferred. * RN required About Baptist Memorial Health Care At Baptist,… more
- Sharecare (Nashville, TN)
- …support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... Hours are on Central Standard Time. **Job Summary:** The RN has the responsibility for supporting the goals and...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Nashville Center for Rehabilitation and Healing (Nashville, TN)
- …trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends ... RN MDS Director Nashville Center for Rehabilitation and...by their supervisor and Administrator MDS Director Qualifications: + Registered Nurse with current, active license in… more
- Baptist Memorial (Memphis, TN)
- …Masters in Nursing or related field Minimum: BSN Experience Preferred: Exp with utilization review processes Minimum: Two years of nursing experience in acute ... RN Facility: Baptist Cancer Center Foundation Department: TC BCC Memphis Category: Nurse RN Type: Clinical Nurse Work Type: Full Time Work Schedule: Days… more
- STG International (Savannah, TN)
- …in the management/coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's philosophy. + ... safety. + Participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement… more
- Covenant Health Inc. (Knoxville, TN)
- …five (3-5) years of experience in a clinical setting, case management, or utilization review experience preferred. Must be computer literate with basic knowledge ... services needed. The Care Navigator works under the guidance of the RN Care Coordinator and Quality Leadership to provide collaborative care management… more
- Houston Methodist (Nashville, TN)
- …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more