- BlueCross BlueShield of Tennessee (Nashville, TN)
- …position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \(RN\) with active license in the state of ... have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases...their residence if the state is participating in the Nurse Licensure Compact Law\. _Experience_ + 3 years \-… more
- 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
- CVS Health (Nashville, TN)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Nashville, TN)
- …Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . **Required Qualifications** + Registered Nurse (RN) ... CVS Health Aetna has an opportunity for a full-time Utilization Management (UM) Nurse Consultant. As a...Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills… 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
- CVS Health (Nashville, TN)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Nashville, TN)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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
- CVS Health (Nashville, TN)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- Schedule . 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 ... patient needs and uses current treatment knowledge in accordance with facilities clinical procedures. This includes but is not limited to: . Performing accurate,… 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
- Evolent (Nashville, TN)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- Veterans Affairs, Veterans Health Administration (Nashville, TN)
- Summary The Nashville VA Medical Center is seeking a highly motivated and experienced Registered Nurse to serve as a Research Nurse within the Research and ... Service. The incumbent will play a critical role in supporting clinical research activities, ensuring regulatory compliance, and promoting Veteran-centered care… more
- Sharecare (Nashville, TN)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… 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)
- …in Nursing required; Master's Degree in Nursing preferred. + Current licensure as a Registered Nurse (RN) in the state of Tennessee or compact state required. ... or limits? Our TriStar Centennial Medical Center team is looking for a Clinical Operations Manager. HCA Healthcare is an advanced healthcare network that has… 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
- 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)
- …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
