- BlueCross BlueShield of Tennessee (Nashville, TN)
- …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... meet their complex needs\. As a Care Transition Case Manager , you will play a vital role in ensuring...have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …through preeminent programs in patient care, education, and research. **Organization:** Utilization Management **Job Summary:** Coordinate, monitor, and evaluate ... the operation of Utilization Management Section of the Utilization Management Department of the Medical Center. . KEY RESPONSIBILITIES + Develop work… 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
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... current licensure in a clinical discipline either as a Nurse ( RN /LPN/LVN) or a Respiratory Therapist (RT)...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates...**Current licensure in a clinical discipline either as a Nurse ( RN /LPN/ LVN)or a Respiratory Therapist… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission...Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited Case Manager … more
- HCA Healthcare (Smyrna, TN)
- …"Code of Conduct" and "Mission and Value Statement" **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree, or Masters Degree, or ... any other healthcare provider. We are seeking a(an) Case Manager RN to join our healthcare family....nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- Elevance Health (Nashville, TN)
- …I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient ... provide an equivalent background. + Current active unrestricted license, such as ** RN LCSW** **LMSW LMHC** **LPC** (as allowed by applicable state laws) **LMFT**… more
- HCA Healthcare (Nashville, TN)
- …Centennial Medical Center have the opportunity to make a real impact. As a(an) Case Manager RN you can be a part of change. **Benefits** TriStar Centennial ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...positive outcomes for your patients as a (an) Case Manager RN . We want your knowledge and… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the PRN career opportunities as a(an) Case Manager RN PRN you want with your current employer? We have an exciting ... colleagues. Do you want to work as a(an) Case Manager RN PRN where your passion for...stay, managing the length of stay, ensuring appropriate resource management and developing a safe appropriate discharge plan in… more
- Elevance Health (Brentwood, TN)
- …unless an accommodation is granted as required by law._ The **LTSS Service Coordinator- RN ** is responsible for overall management of member's case within the ... **LTSS Service Coordinator - RN ** **Location:** The location for this position includes Knox, Anderson, Claiborne, Williamson, Davidson, Montgomery, Shelby, Tipton,… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... sickle cell, brain injuries, oncology\-related needs\)\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine… more
- Humana (Nashville, TN)
- …your skills to make an impact** **Required Qualifications** + Associate's degree + Licensed Registered Nurse ( RN ) in the (appropriate Compact state) with no ... community and help us put health first** The Care Manager , Telephonic Nurse 2 within the Clinical...Clinical Access Grievance Team utilizes clinical nursing skills and utilization management to support the coordination, documentation,… more
- Sharecare (Nashville, TN)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... program intervention guidelines. A Disease Management Nurse is supervised by an Operations Manager ...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Deloitte (Nashville, TN)
- …as clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN , ... Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical… more
- Elevance Health (Brentwood, TN)
- …Coordinator-Clinician** is responsible for working under the direction/supervision of an RN , with overall responsibility for the member's case. As required by ... the scope of licensure including, for example, assisting the responsible RN with telephonic or face-to-face assessments for the identification, evaluation,… more
- Highmark Health (Nashville, TN)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
