- Community Health Systems (Franklin, TN)
- **Job Summary** The Manager of Utilization Review oversees a team of utilization review nurses and coordinators, ensuring compliance with clinical ... Relations Manager to facilitate coordination of services related to utilization review . Collaborates with the multidisciplinary team, lending professional… more
- Wellpath (Franklin, TN)
- …make a difference** The Regional Care Manager (RCM) is responsible for utilization review , care coordination, and daily care management across multiple sites ... Nursing or Care Management Certification + RN preferred EXPERIENCE + Previous utilization review and/or case management and pre-certification experience +… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital...Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited Case Manager … more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... secure timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities,… more
- Evolent (Nashville, TN)
- …and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point...to determine if submitted requests require a prior authorization review or redirect as required. + Entering data into… more
- Deloitte (Nashville, TN)
- …+ Experience as clinical registered nurse, physician, physician assistant, case manager , clinical documentation specialist, utilization review , informatics ... RN, Quality, DRG Validation and health IT preferred + Knowledge of Medicare reimbursement system and coding structures preferred + In-depth knowledge and experience in medical terminology, medical coding, and ICD-10-CM/PCS, IPPS payment system is a plus' +… more
- SAM LLC (Nashville, TN)
- …Manager . A Phase Manager also serves as the backup to their Project Manager , assisting with billing review , and proposal writing and review . + Execute ... responsible for oversight and reporting on spending and budget, utilization of resources, tracking deliverables, handling of field and... also serves as the backup to their Project Manager , assisting with billing review , and proposal… more
- Republic Services (Murfreesboro, TN)
- …and monitor all required testing, including sampling of monitoring wells; monitors utilization of cover material; review soil reports and provide information ... **POSITION SUMMARY:** Within a business unit, the Operations Manager - Landfill manages the landfill operations to...with safety, environmental and equipment maintenance policies. The Operations Manager - Landfill works closely with the General … more
- CBRE (Nashville, TN)
- Global Procurement Sr Manager Job ID 249034 Posted 24-Nov-2025 Service line GWS Segment Role type Full-time Areas of Interest Purchasing/Procurement Location(s) ... industry. **About the Role:** As a CBRE Procurement Sr. Manager , you'll be responsible for managing a large team...strategy at local, regional, and global levels. + Draft, review , negotiate, and maintain contracts and other business documents… more
- J&J Family of Companies (Nashville, TN)
- …the Johnson & Johnson Family of Companies, is recruiting for an Account Manager for **Nashville, TN** . Territory covers states of **Georgia and Alabama.** NeuWave ... on their journey to wellness. Learn more at https://www.jnj.com/medtech The Account Manager is primarily responsible for developing and executing business plans to… more
- CVS Health (Nashville, TN)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Oracle (Nashville, TN)
- …build, testing and deployment. + Works closely with management - Portfolio Manager and the roles within the pods (eg, Business Analyst, Integration Specialist, ... procedures, contractual budgets, providing expert-level insight on the development, utilization , and revision of contractual agreements. + Maintains customer… more
- Capital One (Nashville, TN)
- Sr. Manager , Technical Writer - Capital One Software (Remote) Ever since our first credit card customer in 1994, Capital One has recognized that technology and data ... leaders that tirelessly seek to question the status quo. As a Capital One Senior Manager , Technical Writing - Data Security, you'll have the opportunity to be on the… more
- HCA Healthcare (Nashville, TN)
- …join an organization that invests in you as a Senior Pharmacy Benefit Account Manager ? At HealthTrust, you come first. HCA Healthcare has committed up to $300 ... We are looking for a dedicated Pharmacy Operations Senior Manager Accounts like you to be a part of...efficiency. + Provide client implementation support and guidance + Review and evaluate changes in formulary strategy including exclusions,… more
- SHI (Nashville, TN)
- …an exciting opportunity available in our PMO team as an Associate Project Manager . The Associate Project Manager manages day-to-day operational and tactical ... position will schedule resources, manage escalations, track hours and budget, review deliverables, and maintain clear communication with stakeholders on project… more
- Norstella (Nashville, TN)
- Client Success Manager Company: MMIT Location: Remote, United States Date Posted: Jan 5, 2026 Employment Type: Full Time Job ID: R-1667 **Description** **About ... access to therapies, by ensuring successful deployment, adoption, and utilization of MMIT's products and services. The CSM is...roles. + Meet regularly with clients to build relationships, review use cases and recent Market Access updates, … more
- Rubrik (Nashville, TN)
- **Distribution Channel Manager ** The **Distribution Channel Manager ** will be directly responsible for activating, managing, and generating significant pipeline ... the distribution channel. + **Drive Operational Excellence:** Ensure optimal utilization of distribution services (eg, inventory, credit, fulfillment, transaction… more
- Prime Therapeutics (Nashville, TN)
- …pharmacy with us. **Job Posting Title** Georgia Medicaid Clinical Account Manager - Remote **Job Description** Innovative business clinician accountable for building ... with pharmacy department or designated customer contacts. + Directs operations account manager in resolving customer service issues and actions supportive of the… more
- Cardinal Health (Nashville, TN)
- …conducts investigations to resolve ethics and compliance issues. **Compliance Audit Manager ** Reporting to the Compliance Director, this position supervises and ... annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. **Responsibilities** +… more
- Ryder System (Nashville, TN)
- …measurable business impact, including time savings, error reduction, and improved resource utilization . The Core Products Manager collaborates closely with our ... _Job Seekers can review the Job Applicant Privacy Policy by clicking...apply using the internal application process. _Job Seekers can review the Job Applicant Privacy Policy by clicking here… more