- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Humana (Nashville, TN)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… 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
- Humana (Nashville, TN)
- …and help us put health first** The Compliance Nurse 2 reviews case management and utilization management activities and documentation to ensure adherence ... Quality leadership. **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse license in the state of Virginia, or obtain a… 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
- Vanderbilt University Medical Center (Nashville, TN)
- …through preeminent programs in patient care, education, and research. **Organization:** Utilization Management 20 **Job Summary:** JOB SUMMARY Facilitates ... that the appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary … more
- Elevance Health (Nashville, TN)
- …commute to the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most ... **Medical Management Nurse ** **Office Location** : Atlanta,...experience and requires a minimum of 2 years clinical, utilization review , or case management … more
- Ascension Health (Nashville, TN)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours a 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)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… 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
- 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
- Sedgwick (Nashville, TN)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
- HCA Healthcare (Nashville, TN)
- …4+ years of experience in acute care preferred + 3+ years of experience in Case Management required + Registered Nurse - Currently licensed as a ... registered professional nurse in the state in which he or she...growth, we encourage you to apply for our Case Management Senior Manager opening. We promptly review … more
- Vanderbilt University Medical Center (Nashville, TN)
- …in embracing the change. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** ... - Outpatient. The Associate Nursing Officer shall provide general management for the operations of a Patient Care Center...or VUMC goals. + Promote and monitor the effective utilization of the assigned space in support of the… more
- Vanderbilt University Medical Center (Nashville, TN)
- …in embracing the change. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** ... a very large, advanced practice provider group, Technicians for epilepsy monitoring, registered nurses, care partners, clinical nurse specialist, clinical staff… more
- Vanderbilt University Medical Center (Nashville, TN)
- …in embracing the change. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** ... research, and patient care missions of the University's Medical Center. + Review , establish, and revise policies, procedures, and standards related to all aspects… more
- HCA Healthcare (Nashville, TN)
- …for Microsoft Word, Excel and PowerPoint preferred. + Demonstrated personal time management and project prioritization skills preferred. + LPN/ RN , Certified ... of supply expense opportunities to improve product standardization and utilization . This process includes product selection, evaluation and implementation of… more