- 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 ... SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action… 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) Compact license, with no… more
- YesCare Corp (Brentwood, TN)
- …Assist in completion of special projects on an as needed basis. **Key Qualifications:** + Registered Nurse (RN) active license + No less than 5 years' experience ... a pioneer in correctional healthcare services, YesCare is committed to innovation, clinical expertise, and compassionate care. By choosing a career with YesCare, you… more
- Humana (Nashville, TN)
- …make an impact** **Required Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... health first** This is an opportunity to use your clinical knowledge and research skills to support the coordination,...an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication,… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Part-Time Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... and collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital … more
- Fresenius Medical Center (Winchester, TN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… 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
- Quality Center for Rehabilitation and Healing (Lebanon, 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
- CenterWell (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… 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 ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Humana (Nashville, TN)
- …**Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse (RN) Multi-state/Compact State license with no disciplinary ... medication adherence and is trained to act as a clinical concierge. The NAL Telephonic Nurse role...care, skilled or rehabilitation setting, home health, DME, triage, utilization , or case management. + **Ability to work ANY… 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
- Select Medical (Memphis, TN)
- **Overview** **Position:** Nurse Manager- Registered Nurse (RN) **Location:** Memphis, TN (Inside of Methodist University Hospital) **Schedule:** Full-time ... vulnerable, painful moments of their lives - and the Nurse Manager plays a central role in providing compassionate,...reimbursement, and continuing education + **Elevate Your Skills** : Clinical ladder programs and certifications such as PCCN and… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …as 4 years of professional work experience in a corporate environment\. + **Licensure:** Registered Nurse \(RN\) with active license in the state of Tennessee or ... Sigma Methodologies + Analytical: Strong business acumen with sound analytical skills Registered Nurse with BSN highly preferred\. Managed care experience with… 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
- Houston Methodist (TN)
- …clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure within ... At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the...60 days **OR** + RN-Temp - Registered Nurse - Temporary State Licensure within… more