- LifePoint Health (Gallatin, TN)
- … management or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** ... Monitors adherence to the hospital's utilization review plan to ensure appropriate use of...admissions and extended hospitals stays. Reports to: Director - Case Management Minimum Education Associate's, Bachelor's degree… more
- Elevance Health (Nashville, TN)
- …ill patients, chronically ill pediatric patients, and patients with IDD. + Home Health, Utilization Management or Case Management experience strongly ... community agencies and appropriate provider/network. + Refers member to catastrophic case management . **Minimum Requirements:** + Requires AS in nursing… more
- Select Medical (Nashville, TN)
- …doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... **Overview** **Critical Illness Recovery Hospital** ** Case Manager (PRN)** _Requires a current...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- HCA Healthcare (Nashville, TN)
- …Bonus available for qualified RN candidates! Do you have the career opportunities as a Case Management RN you want in your current role? We invest in what ... Eligibility for benefits may vary by location. The RN Case Manager is responsible for promoting patient-centered...What you will do in this role: + Provides case management services for both inpatient and… more
- Elevance Health (Nashville, TN)
- …and ensures essential face-to-face onboarding and skill development. The **Nurse Case Manager II** will be responsible for care management within the scope ... **Nurse Case Manager II** **Location:** This role...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Cardinal Health (Nashville, TN)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient ... guidance and training to junior case managers on best practices in case management , patient interaction, and navigating internal and external systems. +… more
- HCA Healthcare (Nashville, TN)
- …like you to be a part of our team. **Job Summary and Qualifications** The Sr. Manager of Case Management Reporting and Analytics is primarily responsible for ... producing HCA's enterprise reports within the Case Management Department. The Sr ...client satisfaction goals within a deadline + Knowledge of case management and/or utilization review… more
- HCA Healthcare (Nashville, TN)
- …health plans. This individual will partner with multiple enterprise teams such as Case Management , Corporate Utilization Review Services (URS) team, Pre-bill ... join an organization that invests in you as a Manager Physician Advisor Coordination? At Parallon, you come first....& Alignment (PCA), and actions related to the denial management processes. **In this role you will:** + Provide… more
- Cornerstone onDemand (Nashville, TN)
- …expansion and customer advocacy. As the trusted partner for the customer on use- case , product functionality and talent management best practices, the CSM ... The Customer Success Manager (CSM) is responsible for a portfolio of...solutions in the Cornerstone platform while increasing adoption and utilization . + Work across the customer's business organization to… more
- Omnicell (Nashville, TN)
- …number of strategic health-system existing customers. This is a strategic account management position. Accounts are target accounts that have a major strategic ... systems customers and ensure strategy is executed. Execute contract business case and account plans, detailing resources and contractual obligations, opportunities,… more
- Community Health Systems (Franklin, TN)
- …the Utilization Review Clinical Specialist. + Monitors and updates case management software with documentation of escalations, avoidable days, authorization ... the process aligns with hospital, corporate, and payer requirements. Documents outcomes in case management systems. + Reviews and closes out cases after patient… more
- Highmark Health (Nashville, TN)
- …Highmark Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned ... and federal law standards and are within the care manager 's professional discipline. + For assigned case ...**Required** + 7 years in any combination of clinical, case / utilization management and/or disease/condition … more
- Sharecare (Nashville, TN)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include… more
- Baker Construction (Nashville, TN)
- …in establishing clinics, managing first report of injuries, and assisting with co-worker case management + Follows Company Recruitment and Hiring Guidelines + ... and other reports + Alerts the Superintendent and Project Manager of project impact relating to resource management...utilization , MBE/SBE participation, etc., and advises the Project Manager of issues + Interfaces with Safety and Risk… more
- Elevance Health (Nashville, TN)
- …preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For ... medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer… more
- CDM Smith (Nashville, TN)
- …of cloud technologies, including design patterns, planning, configuration, and resource management in Microsoft Azure and other cloud platforms. * Develop DevSecOps ... (AAD), RBAC, IAM configuring role assignments, conditional access, and identity management . * Incorporate security best practices into cloud architecture and ensure… more
- SitusAMC (Nashville, TN)
- …automation to streamline repetitive tasks and improve overall efficiency. + **Resource Management ** + Manage resource allocation, ensuring that team members have the ... and address potential resource constraints or bottlenecks. + Report on resource utilization and manage capacity for the team. + **Project Planning and Coordination**… more
- NASCO (Nashville, TN)
- …including but not limited to batch cycle job flow, integration points, API utilization , and Duty Manager information + Assists in developing department process ... to meet their business goals. Communicates project status and initiatives to management . **Responsibilities** + Collaborates with Vendors and NDT to resolve system… more
- Evolent (Nashville, TN)
- …on value- based care and initiatives within pathway, policy, and beyond utilization management solutions. + Introduce innovative initiatives supported with ... for provider portal, prior authorizations, lists, regimens, scope diagnoses, case review and related activities. + Review of Carepro...serve as the clinical lead (SME) on the Rules Manager Team. + Ability to travel 15% for external… more