- Cognizant (Nashville, TN)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… 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 assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact 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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... and collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital … more
- Select Medical (Nashville, TN)
- …mechanical ventilation liberation rates. **Qualifications** Minimum requirements: + Permanent State Registered Nurse License and Certificate of Authority. + ... such as medication errors, falls, and hospital-acquired pressure ulcers. Champions nurse -driven protocols to decrease urinary catheter utilization rates and… 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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Vanderbilt University Medical Center (Nashville, TN)
- …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... patients and families from the beginning - Autonomy and Utilization of Critical Skills - Teamwork that displays comradery...of the healthcare team. Has experience in gathering pertinent clinical data that aid in referral, treatment, or other… more
- Humana (Nashville, TN)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... of action. The Utilization Management Behavioral Health Nurse uses clinical knowledge, communication skills, and...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Deloitte (Nashville, TN)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
- Vanderbilt University Medical Center (Nashville, TN)
- …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... and research. **Organization:** MCJCHV Nursing Education **Job Summary:** The clinical education facilitator, PRN participates in the assessment, planning,… more
- HCA Healthcare (Nashville, TN)
- …evaluation and utilize adult learning principles - Required + Currently licensed as a registered professional nurse in the state(s) in which he or she practices, ... area. This includes educational aspects of orientation and onboarding of clinical employees, clinical professional development, and development of education… more
- Datavant (Nashville, TN)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Vanderbilt University Medical Center (Nashville, TN)
- …research. **Organization:** Neonatal/Ped Trnsprt Cohort 10 **Job Summary:** JOB SUMMARY The Registered Nurse provides critical care to neonatal and pediatric ... instead of emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** Relevant… more
- HCA Healthcare (Nashville, TN)
- …or instruction of Clinical EHR application - Required + Currently licensed as a registered nurse or allied health professional in the state(s) in which he or ... platform. This includes the educational aspects of orientation and onboarding of clinical employees and development of education that addresses EHR practice gaps for… more
- HCA Healthcare (Nashville, TN)
- …Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse (RN) licensure , Licensed Clinical Social Worker (LCSW) or ... actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational aspects of the… more
- Highmark Health (Nashville, TN)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more