- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
- Houston Methodist (TN)
- …caring for adults in an acute care hospital setting + Coding and utilization review experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN ... At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the overall quality and completeness of clinical documentation. This… more
- HCA Healthcare (Nashville, TN)
- …UT, VA). Do you want to join an organization that invests in you as a Clinical Appeals Specialist Medicare RN or LPN? At Parallon, you come first. HCA Healthcare ... make a difference. We are looking for a dedicated Clinical Appeals Specialist Medicare RN or LPN...today! What you will do in this role: + Review medical records and other documentation to compose RAC… more
- Cognizant (Nashville, TN)
- …and retro-authorization as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral, preauthorization, ... determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with...background - Registered Nurse (RN) . 2-3 years combined clinical and utilization management experience with managed… more
- HCA Healthcare (Nashville, TN)
- …face or telemedicine assessment completed and physician consult. + Provides a thorough clinical review and risk assessment with appropriate level of care ... treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile… more
- HCA Healthcare (Nashville, TN)
- …operations, policies, systems and procedures necessary to support cost reduction and system utilization goals. + Provide monthly KPI's for review and regular ... Do you want to join an organization that invests in you as a Sr Specialist Workforce Planning and Integration? At HCA Healthcare, you come first. HCA Healthcare has… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Sr. Specialist Labor Performance Improvement? At HCA Healthcare, you come first. HCA Healthcare has ... a difference. We are looking for a dedicated Sr. Specialist Labor Performance Improvement like you to be a...Develops processes to support improved operations (such as sitter utilization , use of various pay codes, overtime management, etc.)… more
- HCA Healthcare (Nashville, TN)
- …join an organization that invests in you as an Expanse Professional Development Specialist ? At HealthTrust, you come first. HCA Healthcare has committed up to $300 ... We are looking for a dedicated Expanse Professional Development Specialist like you to be a part of our...includes the educational aspects of orientation and onboarding of clinical employees and development of education that addresses EHR… more
- Evolent (Nashville, TN)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Covenant Health Inc. (Knoxville, TN)
- …identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist , as necessary to ensure appropriate ... The RN Care Coordinator II is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education of staff and… more
- Covenant Health Inc. (Harriman, TN)
- …identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist , as necessary to ensure appropriate ... Summary: The RN Care Manager II is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education of staff and… more
- Covenant Health Inc. (Harriman, TN)
- …meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist + As necessary to ensure ... Summary: The RN Care Manager III is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education of staff and… more
- Covenant Health Inc. (Lenoir City, TN)
- …identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist , as necessary to ensure appropriate ... Summary: The RN Care Manager II is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education of staff and… more
- Covenant Health Inc. (Knoxville, TN)
- …identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist as necessary to ensure appropriate ... Summary: The RN Care Manager III is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education of staff and… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Clinical Supervisor, HomeCare Nursing Administration $1,500 Sign-on Bonus for Candidates with Relevant HomeCare Homebase Experience Full ... , our region's top-performing healthcare network. Position Summary: The Clinical Field Staff Supervisor (CFSS) ensures the overall coordination of… more