- 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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Sharecare (Nashville, TN)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- Molina Healthcare (Bowling Green, KY)
- …receptive including home , nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and provide ... 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a home health,...home health as a licensed clinician, especially in management of chronic conditions + Experience with underserved populations… more
- Molina Healthcare (Bowling Green, KY)
- …(EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, community health or public health ... in home health as a licensed clinician, especially in management of chronic conditions. * Experience with underserved populations facing socioeconomic barriers… more
- Humana (Nashville, TN)
- …as Interqual, etc.) **Preferred Qualifications** + Utilization Review/Quality Management experience + BA/BSN degree **Work-At- Home Requirements** + WAH ... of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following… more
- Lincoln Financial (Nashville, TN)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at ...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position… more
- Evolent (Nashville, TN)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
- Nashville Center for Rehabilitation and Healing (Nashville, TN)
- …team. The RN/LPN Supervisor assumes primary nursing responsibilities for the management of resident and staff activities. The RN/LPN Supervisor utilizes nursing ... practice and management skills and ensures resident care is administered in...nursing care is delivered which is outcome focused through utilization of the nursing process. Identify needs and provide… more
- HCA Healthcare (Hendersonville, TN)
- …to join an organization that invests in you as a(an) Director Case Management ? At TriStar Hendersonville Medical Center, you come first. HCA Healthcare has committed ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Molina Healthcare (Bowling Green, KY)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- HCA Healthcare (Nashville, TN)
- …required (LPC, LMFT, LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with required DSM V-R ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- HCA Healthcare (Nashville, TN)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity… more
- HCA Healthcare (Nashville, TN)
- …labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintain staffing to ensure ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Sharecare (Nashville, TN)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- HCA Healthcare (Nashville, TN)
- …They Manage department operations to include staff schedule, staff productivity, resource utilization and expense management to ensure quality patient care and ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Gentiva (Nashville, TN)
- …licensed Registered Nurse (RN) with strong leadership experience in hospice care, home health, or clinical operations management . If you're a natural leader ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- HCA Healthcare (Bowling Green, KY)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... + Referral services for child, elder and pet care, home and auto repair, event planning and more +...Supervisor participates as an active member of the nursing management team and assumes authority to manage all activities… more
- HCA Healthcare (Nashville, TN)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity… more
- HCA Healthcare (Nashville, TN)
- …for delivering quality, responsive curriculum and programs. + Ensures that the number, utilization , and credentials of staff and non- nurse faculty are sufficient ... partnerships, and serves as an integral member of the College and Campus management team. This position will also ensure teaching excellence, faculty and student… more