- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
- Deloitte (Nashville, TN)
- …registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk… more
- YesCare Corp (Brentwood, TN)
- …standards of best practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. + Track, trend and ... a pioneer in correctional healthcare services, YesCare is committed to innovation, clinical expertise, and compassionate care. By choosing a career with YesCare, you… more
- HCA Healthcare (Nashville, TN)
- …face or telemedicine assessment completed and physician consult. + Provides a thorough clinical review and risk assessment with appropriate level of care ... treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile… more
- HCA Healthcare (Nashville, TN)
- …operations, policies, systems and procedures necessary to support cost reduction and system utilization goals. + Provide monthly KPI's for review and regular ... Do you want to join an organization that invests in you as a Sr Specialist Workforce Planning and Integration? At HCA Healthcare, you come first. HCA Healthcare has… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Sr. Specialist Labor Performance Improvement? At HCA Healthcare, you come first. HCA Healthcare has ... a difference. We are looking for a dedicated Sr. Specialist Labor Performance Improvement like you to be a...Develops processes to support improved operations (such as sitter utilization , use of various pay codes, overtime management, etc.)… more
- Datavant (Nashville, TN)
- …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... recognized medical necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed… more
- HCA Healthcare (Nashville, TN)
- …join an organization that invests in you as an Expanse Professional Development Specialist ? At HealthTrust, you come first. HCA Healthcare has committed up to $300 ... We are looking for a dedicated Expanse Professional Development Specialist like you to be a part of our...includes the educational aspects of orientation and onboarding of clinical employees and development of education that addresses EHR… more
- Evolent (Nashville, TN)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- HCA Healthcare (Nashville, TN)
- …Fellowship programs (HCA Healthcare Nurse Residency), HCA Healthcare Center for Clinical Advancement (HHCCA) Preceptor Program, and other transition to practice ... programs within Clinical Education. In this role, you will support and...and efficiency of the competency management program through the review of evidence for best practices in competency management.… more