- BlueCross BlueShield of Tennessee (Nashville, TN)
- …position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \(RN\) with active license in the state of ... cell, brain injuries, oncology\-related needs\)\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases as… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- …position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \(RN\) with active license in the state of ... have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases...their residence if the state is participating in the Nurse Licensure Compact Law\. _Experience_ + 3 years \-… more
- Cognizant (Nashville, TN)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Nashville, TN)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Select Medical (Nashville, TN)
- …mechanical ventilation liberation rates. **Qualifications** Minimum requirements: + Permanent State Registered Nurse License and Certificate of Authority. + ... such as medication errors, falls, and hospital-acquired pressure ulcers. Champions nurse -driven protocols to decrease urinary catheter utilization rates and… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …by the state of Kentucky or hold license in a compact state as a Registered Nurse . ACLS preferred. Required Certifications: Basic Life Support (BLS) must be ... Registered Nurses are accountable for providing safe and...of care set by state board of nursing, state nurse practice act, and other governing agency regulations. Resolving… more
- Molina Healthcare (Bowling Green, KY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support...hearings as may be required. * Serves as a clinical resource for utilization management, chief medical… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- Schedule . 5 days a week 37.5 - 40 hours per week Respiratory Nurse (RN) We are searching for a highly motivated, flexible, organized, skilled respiratory therapist ... patient needs and uses current treatment knowledge in accordance with facilities clinical procedures. This includes but is not limited to: . Performing accurate,… more
- Vanderbilt University Medical Center (Nashville, TN)
- …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... patients and families from the beginning - Autonomy and Utilization of Critical Skills - Teamwork that displays comradery...of the healthcare team. Has experience in gathering pertinent clinical data that aid in referral, treatment, or other… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …Emergency Department. Provide care to patients within the scope of practice of a Registered Nurse as defined by the Kentucky Board of Nursing. ESSENTIAL ... appropriate care. * Delegates duties based on complexity of patient needs. * Utilization of critical thinking skills in prioritization of care. * Develops and… more
- CenterWell (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- To ensure the delivery of competent, high quality clinical care in a caring compassionate environment. * Completes nursing HX and assessment accurately within ... appropriate care. * Delegates duties based on complexity of patient needs. * Utilization of critical thinking skills in prioritization of care. * Develops and… more
- Humana (Nashville, TN)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Molina Healthcare (Bowling Green, KY)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in ... for denial or modification of payment decisions. + Serves as a clinical resource for utilization management, CMOs, physicians and member/provider… more
- Humana (Nashville, TN)
- …**Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse (RN) Multi-state/Compact State license with no disciplinary ... medication adherence and is trained to act as a clinical concierge. The NAL Telephonic Nurse role...care, skilled or rehabilitation setting, home health, DME, triage, utilization , or case management. + **Ability to work ANY… more
- Sharecare (Nashville, TN)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Deloitte (Nashville, TN)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
