- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities,… more
- Sedgwick (Nashville, TN)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign ... utilization review requests; to verify and enter data in appropriate...and RESPONSIBILITIES** + Accesses, triages and assigns cases for utilization review (UR). + Responds to telephone… more
- Humana (Nashville, TN)
- …new systems (proficient to advanced) **Preferred Qualifications** + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... and help us put health first** The UM Administration Coordinator contributes to administration of utilization management....the nursing team + Builds and pends authorizations for review + Responsible for inbound and outbound calls to… 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 ... We're a proud member of Covenant Health! Position Summary: The RN Care Coordinator II is responsible for integrating evidenced based clinical practice into the… more
- Humana (Nashville, TN)
- … or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- Humana (Nashville, TN)
- …utilizing electronic medical record and documentation programs + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... + Knowledge of Medical Terminology and/or ICD-10 codes + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
- Manchester Center for Rehabilitation and Healing (Manchester, TN)
- …trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends ... MDS Coordinator Manchester Center for Rehabilitation and Healing is...and Healing is looking for talented and motivated MDS Coordinator to join our dynamic team. The position is… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Certified MDS Coordinator , Transitional Care PRN/OCC, Variable Hours, Day Shift Fort Sanders Regional Overview: Fort Sanders Regional Medical Center is an ... in a manner that accurately captures the RUG (Resource Utilization Group) category. + Will provide a schedule of...as needed based on timeliness of completion. The MDS Coordinator is expected to report any issues with timely… more
- Trevecca Center for Rehabilitation and Healing (Nashville, TN)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... the administrator in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers to achieve budget… more
- Covenant Health Inc. (Knoxville, TN)
- …Continuum of Care: The Continuum of Care Department is staffed by a Manager, Coordinator , RN Care Managers, and Masters Level Social Workers. They are involved in ... the Leadership team on the nursing unit and reports directly to the Manager/ Coordinator of Quality and Care Management at the facility level Recruiter: Angelica… more
- Manchester Center for Rehabilitation and Healing (Manchester, TN)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... the facility with the director of nursing, nurse managers, and admissions coordinator to assist in development of the respiratory therapy program. . Establishing… more
- Covenant Health Inc. (Knoxville, TN)
- …and as employee turnover occurs. + Participates with clinical, financial and utilization review departments to address opportunities to improve overall ... Overview Outpatient Pre-Certification Coordinator , Tennessee Brain & Spine Full Time, 72 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's… more
- Covenant Health Inc. (Harriman, TN)
- …Leadership team on the nursing unit and reports directly to the Manager/ Coordinator of Quality and Care Management at the facility level. Recruiter:Sandra Simmons ... the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist, as necessary to… more
- Covenant Health Inc. (Harriman, TN)
- …the Leadership team on the nursing unit and reports directly to the Manager/ Coordinator of Quality and Care Management at the facility level Recruiter:Sandra Simmons ... the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist + As necessary to… more
- Covenant Health Inc. (Lenoir City, TN)
- …the Leadership team on the nursing unit and reports directly to the Manager/ Coordinator of Quality and Care Management at the facility level. Recruiter: Sandra ... the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist, as necessary to… more