- Medalogix (Nashville, TN)
- …2025, Forcura, the intelligent workflow management company, and Medalogix, a clinical decision support company, announced that they have combined. Together, the ... the merging of Forcura and Medalogix. Position Summary The Director, Clinical Operations leverages his/her extensive knowledge managing multiple agency locations to… more
- Evolent (Nashville, TN)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- HCA Healthcare (Hendersonville, TN)
- …recognized. Submit your application for the opportunity below: Clinical Nurse Coordinator Med SurgTriStar Hendersonville Medical Center **Benefits** TriStar ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...encourage you to apply for our Clinical Nurse Coordinator Med Surg opening. We promptly review… more
- Molina Healthcare (Bowling Green, KY)
- JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely ... Friday 8:00am - 5:00pm. **Essential Job Duties** * Performs clinical / medical reviews of retrospective medical ...hospital setting, including at least 1 year of utilization review , medical claims review , claims… more
- Vanderbilt University Medical Center (Nashville, TN)
- …home for clinical and translational research. Supported by Vanderbilt University Medical Center's Office of Research and the NIH-sponsored Clinical and ... **Discover Vanderbilt University Medical Center** : Located in Nashville, Tennessee, and...our day shift for 4-9-hour shifts in our Children's Clinical Research Center. We have scheduled outpatient research visits… more
- Molina Healthcare (Bowling Green, KY)
- …for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for ... Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review...clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review .… more
- Cognizant (Nashville, TN)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. . Medical Necessity Reviews can… more
- HCA Healthcare (Springfield, TN)
- …is important to you, we encourage you to apply for our Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator and access programs to...Registered Nurse + Associate Degree, or Registered Nurse Diploma TriStar NorthCrest Medical Center is… more
- HCA Healthcare (Nashville, TN)
- …we encourage you to apply for our Acute Care Surgical Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... positions. Join our Team as a(an) Acute Care Surgical Clinical Nurse Coordinator and access programs to...within 30 days of employment start date + Registered Nurse + Bachelors Degree preferred TriStar Centennial Medical… more
- HCA Healthcare (Smyrna, TN)
- …and personal growth, we encourage you to apply for our Clinical Nurse Coordinator opening. We promptly review all applications. Highly qualified candidates ... We care like family! Jump-start your career as a Clinical Nurse Coordinator today with Physicians Pavilion...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- HCA Healthcare (Nashville, TN)
- …step in your career path, we encourage you to apply for our RN Rehab Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... colleagues in their positions. Join our Team as a Clinical Nurse Coordinator on our Rehab Unit...within 30 days of employment start date + Registered Nurse + Associate Degree TriStar Skyline Medical … more
- HCA Healthcare (Hendersonville, TN)
- …growth, we encourage you to apply for our Cardiac Clinical Nurse Coordinator opening. We promptly review all applications. Highly qualified candidates ... Do you have the career opportunities as a(an) Cardiac Clinical Nurse Coordinator you want with your...an exciting opportunity for you to join TriStar Hendersonville Medical Center which is part of the nation's leading… more
- HCA Healthcare (Nashville, TN)
- …is important to you, we encourage you to apply for our Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... deliver excellent care patients deserve? At TriStar Southern Hills Medical Center we support our colleagues in their positions....colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator and access programs to… more
- HCA Healthcare (Nashville, TN)
- …TriStar Centennial Medical Center! **Job Summary and Qualifications** The Clinical Nurse Coordinator (CNC) ensures and delivers high quality, ... an exciting opportunity for you to join TriStar Centennial Medical Center which is a part of the nation's...encourage you to apply for our Labor and Delivery Clinical Nurse Coordinator opening. We review… more
- HCA Healthcare (Nashville, TN)
- …TriStar Centennial Medical Center! **Job Summary and Qualifications** The Clinical Nurse Coordinator (CNC) ensures and delivers high quality, ... 30 days of employment start date + (RN) Registered Nurse + Bachelors Degree **Benefits** TriStar Centennial Medical...we encourage you to apply for our Acute Care Clinical Nurse Coordinator opening. We review… more
- HCA Healthcare (Nashville, TN)
- …is important to you, we encourage you to apply for our Freestanding ER Nurse opening. Our team will promptly review your application. Highly qualified candidates ... to deliver excellent care patients deserve? At TriStar Centennial Medical Center we support our colleagues in their positions....their positions. Join our Team as a(an) Freestanding ER Nurse and access programs to assist with every stage… more
- HCA Healthcare (Hermitage, TN)
- …at TriStar Summit Medical Center! **Job Summary and Qualifications** The Clinical Nurse Coordinator (CNC) ensures and delivers high quality, patient-centered ... **Description** **TriStar Summit Medical Center is proud to receive the American...encourage you to apply for our Clinical Nurse Coordinator - AC Cardiopulmonary opening. We review… more
- HCA Healthcare (Nashville, TN)
- … Center we support our colleagues in their positions. Join our Team as ** Clinical Decision Unit Registered Nurse ** **(CDU)** and access programs to assist with ... every stage of your career. Benefits TriStar Skyline Medical Center, offers a total rewards package that supports...may vary by location. Job Summary and Qualifications The Clinical Decision Unit Registered Nurse will provide… more
- HCA Healthcare (Bowling Green, KY)
- …is important to you, we encourage you to apply for our Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator and access programs to...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Elevance Health (Nashville, TN)
- ** Nurse Audit Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the exception ... formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Nurse Audit Senior** will be responsible… more
