- 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
- 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 ... and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization ...of Medical Terminology and/or ICD-10 codes + Experience with Utilization Review and/or Prior Authorization, preferably within… more
- Humana (Nashville, TN)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization ...Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2… 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