- 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
- 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
- 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
- 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
- Veterans Affairs, Veterans Health Administration (Murfreesboro, TN)
- …and make recommendations for improvement. (b) Coordinates the development and effective utilization of knowledge of SQL database structures to write custom queries ... data activity logs to serve as Subject Matter Experts (SMEs). Ensures utilization of logs and associated data elements 10 effectively investigate CMOP prescription… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, 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