• Utilization Review Services

    HCA Healthcare (Nashville, TN)
    …**Introduction** Do you want to join an organization that invests in you as a Utilization Review Services Registered Nurse? At Parallon, you come ... 3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off...make a difference. We are looking for a dedicated Utilization Review Services Registered more
    HCA Healthcare (05/13/25)
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  • Interim RN Director Utilization

    Ascension Health (Nashville, TN)
    …and salary range at the time of the offer._ **Responsibilities** Direct services , workflow and resources for assigned nursing travelers. + Develop departmental goals ... + Direct clinical activities, including patient assessment, care plan development, service level determination, patient visits, and complaint management. + Prepare… more
    Ascension Health (04/24/25)
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  • Utilization Management Specialist, ED (RN…

    Vanderbilt University Medical Center (Nashville, TN)
    …that the appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary ... difficulty. * Clinical Applications Systems (Novice): Possesses fundamental proficiency in utilization review systems, clinical support systems and business… more
    Vanderbilt University Medical Center (05/15/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Nashville, TN)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is ... stratification level. + Identifies participant barriers to accessing health care services . Coordinates with Provider Service Managers and/or other members… more
    Sharecare (05/10/25)
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  • Hospice Registered Nurse RN Full Time

    Aveanna Healthcare (Franklin, TN)
    …the plan of care and patient needs. + Participates in quality improvement, utilization review , and infection control activities as requested. + Attends ... Hospice Registered Nurse RN Full Time ApplyRefer a FriendBack...+ Ensures the timely and adequate delivery of hospice services to the terminally ill patient and their family,… more
    Aveanna Healthcare (04/28/25)
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  • Registered Nurse - High-Risk Surgical…

    Vanderbilt University Medical Center (Nashville, TN)
    …if additional records requests or actions might be indicated * Experience/proficiency in the review and the utilization of EPIC and/or eStar including the Media ... floating within the Hi-RiSE TVC Clinic and floating to the VPEC OHO Clinic * Comfortable with the clinical review of testing results and visit plans to determine… more
    Vanderbilt University Medical Center (02/24/25)
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  • Registered Dietitian - Remote

    Sharecare (Nashville, TN)
    …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... orientation and to take the pre and post-test to review competency during orientation. Yearly competency test is required...Functions:** + Achievement of Clinical Objectives: + Deliver dietary services within the RD scope of practice to members… more
    Sharecare (05/03/25)
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  • Respiratory Registered Nurse

    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 ... standards of conduct and clinical code of ethics and practice. . Implementing in- services and training. . Maintaining a current body of knowledge in areas of… more
    Gallatin Center for Rehabilitation and Healing (04/19/25)
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  • Clinical Reviewer, Nurse (Pain Mngt)

    Evolent (Nashville, TN)
    …+ Reviews charts and analyzes clinical record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which ... Nurse, you will be a key member of the utilization management team. We can offer you a meaningful...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
    Evolent (05/16/25)
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  • Director Regulatory and Accreditation WFH

    HCA Healthcare (Nashville, TN)
    …assessments of focused topics within HCA Healthcare hospitals/ASCs including credentialing, utilization management, peer review , medical staff and board bylaws, ... include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay....3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more
    HCA Healthcare (04/20/25)
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  • Clinical Resources Manager

    HCA Healthcare (Nashville, TN)
    …plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug ... and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options...3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more
    HCA Healthcare (03/30/25)
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  • Population Health Management Clinical Pharmacist…

    Elevance Health (Nashville, TN)
    …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our… more
    Elevance Health (05/13/25)
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  • Expanse Professional Development Specialist

    HCA Healthcare (Nashville, TN)
    …plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug ... and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options...3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more
    HCA Healthcare (05/08/25)
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  • Clinical Pharmacist Specialist BMT Oncology PRN

    HCA Healthcare (Nashville, TN)
    …from Home which is part of the nation's leading provider of healthcare services , Methodist Healthcare. **Benefits** Work from Home, offers a total rewards package ... include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay....3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan + Retirement readiness… more
    HCA Healthcare (03/23/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Nashville, TN)
    …Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like to work here?** At ... Rehabilitation Coordinators (VRC) and others to support with return-to-work services * Effectively manages assigned caseload within department productivity goals… more
    Lincoln Financial (04/30/25)
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  • Clinical Letter Writer - UM & Specialty Experience…

    Evolent (Nashville, TN)
    …years of direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + **Cardiology and Oncology ... for the mission. Stay for the culture. **What You'll Be Doing:** Our shared services team offers candidates the opportunity to make a meaningful impact by providing… more
    Evolent (04/25/25)
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