- BlueCross BlueShield of Tennessee (Memphis, TN)
- …as travel is required to meet with members\.** **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases as ... **SelectCommunity at BCBST is seeking a Registered Nurse ** who is compassionate about case management...acuity\. This role requires telephonic contacts and in person home visits with members on at least a monthly… 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...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
- CenterWell (Nashville, TN)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- CVS Health (Nashville, TN)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Fresenius Medical Center (Lebanon, TN)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… 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
- 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
- Covenant Health Inc. (Lenoir City, TN)
- Overview Registered Nurse Care Manager, Quality Management Full Time, 80 Hours per Pay Period, Day Shift Fort Loudoun Medical Center Overview: Fort Loudoun ... reports directly to the Manager/Coordinator of Quality and Care Management at the facility level. Recruiter: Sandra Simmons ||...and Coordination of Care: + Collaborates directly with the Nurse Manager to ensure the staff adheres to sound… more
- Sevita (TN)
- …state strategy to increase census, maintain occupancy, improve daily attendance, and maximize utilization . + Financial Management : + May be responsible for the ... career well lived. **State Nursing Director - IDD Services (Registered Nurse )** **_Starting Pay: $110,000_** **_Regular travel required_** Looking for rewarding work… 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
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift About Us Covenant Medical Group employs or manages ... Cumberland Plateau so that medical care is close to home - ensuring you get the right care at...Coordinator II reports directly to the Manager of Quality Management at the corporate level. Recruiter:Sandra Simmons || ###@covhlth.com… 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
- Covenant Health Inc. (Knoxville, TN)
- …administrative and regulatory purposes. + Develops and directs efficient materials management process. Ensures cost-efficient ordering and utilization of ... Overview Nurse Manager of Oncology Clinic & Infusion Center...cancer and radiation centers closer to where you call home . All Thompson Oncology Group practices are committed to… more
- Covenant Health Inc. (Harriman, TN)
- …and reports directly to the Manager/Coordinator of Quality and Care Management at the facility level. Recruiter:Sandra Simmons || ###@covhlth.com Responsibilities + ... patient is meeting daily objectives. + Modifies the case management plan to meet the changing needs of the...appropriate disciplines are available + Collaborates directly with the Nurse Manager to ensure the staff adheres to sound… more
- Covenant Health Inc. (Harriman, TN)
- …and reports directly to the Manager/Coordinator of Quality and Care Management at the facility level Recruiter:Sandra Simmons ||###@covhlth.com Responsibilities + ... patient is meeting daily objectives. + Modifies the case management plan to meet the changing needs of the...appropriate disciplines are available + Collaborates directly with the Nurse Manager to ensure the staff adheres to sound… 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, ... + Referral services for child, elder and pet care, home and auto repair, event planning and more +...location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Manager, Social Services PRN/OCC, Variable Hours and Shifts Fort Sanders Regional Overview: Fort Sanders Regional Medical Center is an ... unit and reports directly to the Manager/Coordinator of Quality and Care Management at the facility level Recruiter: Lacey Spoon || ###@covhlth.com Responsibilities… more
