- Community Health Systems (Franklin, TN)
- **Job Summary** The Part-Time Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- YesCare Corp (Brentwood, TN)
- …+ Assist in completion of special projects on an as needed basis. **Key Qualifications:** + Registered Nurse ( RN ) active license + No less than 5 years' ... lives through care and expertise. **Key Responsibilities:** + The nurse will focus on what's best for the patients...practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. +… more
- Deloitte (Nashville, TN)
- …degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical Documentation Specialist - CCDS (inpatient) ... registered nurse , physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN , Quality,… more
- Datavant (Nashville, TN)
- …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... any other healthcare provider. We are seeking a(an) Assessment Specialist PRN to join our healthcare family. **Benefits** TriStar...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
- HCA Healthcare (Nashville, TN)
- …or instruction of Clinical EHR application - Required + Currently licensed as a registered nurse or allied health professional in the state(s) in which he ... join an organization that invests in you as an Expanse Professional Development Specialist ? At HealthTrust, you come first. HCA Healthcare has committed up to $300… more