- CVS Health (Nashville, TN)
- …of Care: + Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and ... Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations… more
- HCA Healthcare (Nashville, TN)
- …Medical Center we support our colleagues in their positions. Join our Team as a(an) Case Manager RN and access programs to assist with every stage of your ... gain certifications and job skills. Apply today for our Case Manager RN opening and continue to...Degree in Nursing (preferred) + 2+ years' experience in case management OR 3+ years' experience in clinical… more
- Highmark Health (Nashville, TN)
- …Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical , case management and/or disease/condition management experience, provider operations ... panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of...interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are… more
- HCA Healthcare (Smyrna, TN)
- …available for qualified RN candidates!** **Introduction** Do you have the career opportunities as a Case Manager RN you want in your current role? We invest in ... StoneCrest Medical Center! **Job Summary and Qualifications** The RN Case Manager is responsible for promoting patient-centered...Masters Degree, or Bachelors Degree + 2+ years in case management OR 3+ years experience in clinical… more
- HCA Healthcare (Nashville, TN)
- …Note: Eligibility for benefits may vary by location. The RN Case Manager is responsible for promoting patient-centered care by ... plan in collaboration with the multidisciplinary team. The RN Case Manager facilitates the progression and transition...Degree in Nursing (preferred) + 2+ years' experience in case management OR 3+ years' experience in clinical… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Case Management Operations Manager ? At HCA Healthcare, you come first. HCA Healthcare ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...part of our team. **Job Summary and Qualifications** The Case Management Operations Manager will be a… more
- HCA Healthcare (Hermitage, TN)
- …nurses set us apart from any other healthcare provider. We are seeking a(an) Case Manager RN to join our healthcare family. **Benefits** TriStar Summit Medical ... their passion for patient care. Apply today for our Case Manager RN opportunity. **Job Summary and...least 2-3 year experience as a nurse in a clinical setting + Case Management experience preferred… more
- Highmark Health (Nashville, TN)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- HCA Healthcare (Nashville, TN)
- …impact and urgency. Automate and improve processes associated with source data (ie, clinical , case management, etc.) integrations to GCP and other products ... **Introduction** Do you have the career opportunities as a Manager , Data Quality you want with your current employer?...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- HCA Healthcare (Nashville, TN)
- …is incentive eligible. **Job Summary and Qualifications** The Regional Coding Operations Manager is responsible for assisting in the development and evolution of the ... workflow, including but not limited to, practice acquisitions, provider clinical documentation improvement, practice coding processes, and division relationship… more
- Elevance Health (Nashville, TN)
- …Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee ... impact:** + Determines the medical necessity of requests using clinical criteria. + Performs physician-level case review...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- HCA Healthcare (Nashville, TN)
- …patient care. Performs in accordance with physician's orders and under the supervision of the Clinical Manager . What you will do in this role: + Assesses home ... and patient/family/caregiver. + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings,… more
- CenterWell (Madison, TN)
- …patients on health maintenance and disease prevention or provide case management. Understands own work area professional concepts/standards, regulations, strategies ... patients on health maintenance and disease prevention or provide case management. Understands own work area professional concepts/standards, regulations, strategies… more
- Valor Health (Columbia, TN)
- …in co-managed care collaboration with non-VA providers, and facilities. + Functions as case manager as needed. + Provides patient and family health education ... Psychiatrist Columbia, TN (http://maps.google.com/maps?q=800+S+James+Campbell+Blvd.+Columbia+TN+USA+38401) * Clinical - Psychiatrist Apply Job Type Full-time Description… more
- CenterWell (Madison, TN)
- …represents the scope of provider relationships across the following areas: + Quality/ clinical management and population health + HEDIS and Stars performance + ... without restriction in applicable state + 5+ years of clinical nursing experience + Proven work experience as a...years of managed care experience + 3+ years of case management experience + Bilingual; English and Spanish preferred,… more
- HCA Healthcare (Nashville, TN)
- …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 ... for claims management, consulting, medical bill review, systems and medical case management. + Ensure accountability among the department for appropriate… more
- HCA Healthcare (Nashville, TN)
- …case follow-up as requested. + Attend educational activities as approved by Manager or Director. + Maintain clinical knowledge of various abstracted measures. ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...+ Communicate in a timely manner with manager to achieve measure compliance. + Submit data timely… more
- CenterWell (Nashville, TN)
- …Intelligence Lead and support ad hoc reporting. * Develop basic modeling and business case analysis; work closely with Finance and Data teams * Coordinate with ACO ... that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time… more
- Highmark Health (Nashville, TN)
- …Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify ... related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges...processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and… more