- 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 ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- CVS Health (Nashville, TN)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... required in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST or CST… more
- Ascension Health (Nashville, TN)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours a week. + **Hospital:** Ascension Saint Thomas + **Location:** ... TN market. We're looking for an experienced Director of Utilization Management to join our team! In...experience required. + 10 years of experience preferred. + 2 years of leadership or management experience… more
- Humana (Nashville, TN)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- Ascension Health (Nashville, TN)
- …Experience: + 5 years of experience required. + 10 years of experience preferred. + 2 years of leadership or management experience required. + 5 years of ... care plan development, service level determination, patient visits, and complaint management . + Prepare and monitor budget(s) and ensure that assigned nursing… more
- Intermountain Health (Nashville, TN)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. + Advocates, educates and coaches… more
- Quality Center for Rehabilitation and Healing (Lebanon, 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 ... the applicable clinical discipline in which licensure or certification is held. 2 . Writes accurate, complete, and clear documentation in accordance with the… more
- Evolent (Nashville, TN)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...business need of nurses providing coverage until 7:00pm CST. 2 days/week 8am - 5pm EST/CST - **Required** +… more
- Select Medical (Nashville, TN)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- HCA Healthcare (Nashville, TN)
- …of supply expense opportunities to improve product standardization and utilization . This process includes product selection, evaluation and implementation of ... department managers to develop, coordinate and integrate supply expense management programs into departmental services by assisting with program implementation,… more
- HCA Healthcare (Nashville, TN)
- …department performance in accordance with established budget, including the utilization of staffing, supplies, and equipment identifying cost reduction opportunities ... practices of the organization through clinical education and competency management . + Consistently seeks improvement opportunities to enhance the effectiveness… more
- Trevecca Center for Rehabilitation and Healing (Nashville, TN)
- …and maximize therapist efficiency. . Managing Medicare Medical Review and Denials Management process in conjunction with the Regional CareRite denials support and ... therapy staff. 2 . Monitors financial performance of rehab department and effectively...development of the annual budget. . Appropriate and effective utilization of staff. . Managing key operations and financial… more
- Dialysis Clinic, Inc. (Nashville, TN)
- …conjunction with Senior Operations Directors, helps to manage financial outcomes, supply utilization , labor management , contract management , and clinical ... in collaboration with Corporate Department of Education and Quality Management . + Presents at AOD and Nurse ...Quality Management . + Presents at AOD and Nurse Manager Meetings and Home Meetings to promote Home… more
- Manchester Center for Rehabilitation and Healing (Manchester, TN)
- …and ensures that appropriate follow-up action is taken + Facilitates the Care Management Process engaging the resident, IDT and family in timely identification and ... trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends various… more