- CoreCivic (Brentwood, TN)
- …_This position will pay $82,000 - $97,400 with a 10% bonus eligible._ **SUMMARY:** The Manager , Utilization Management / Case Management provides ... better the public good. CoreCivic is currently seeking a ** Manager , Health Services Audits** located at our corporate office...Utilization Review and Case Management functions for the organization under the direction of… more
- Molina Healthcare (Bowling Green, KY)
- …Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified ... Responsible for the development, implementation, and delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. Leads… more
- LifePoint Health (Gallatin, TN)
- … or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** *Tennessee-Gallatin* ... 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
- Molina Healthcare (Bowling Green, KY)
- …the pharmacy benefit changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary care team. ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… 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)
- …Centennial Medical Center have the opportunity to make a real impact. As a(an) RN Case Manager you can be a part of change. Benefits TriStar Centennial Medical ... improve positive outcomes for your patients as a (an) Case Manager Nurse. We want your knowledge...What you will do in this role: + Provides case management services for both inpatient and… 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
- CVS Health (Nashville, TN)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... This position consists of working intensely as a telephonic case manager with patients and their care...overcome barriers to meeting goals and objectives - Utilizes case management processes in compliance with regulatory… more
- CVS Health (Franklin, KY)
- …it all with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in ... telephonic contact to assess, plan, implement and coordinate all case management activities with members to evaluate...to facilitate and support the member's improved health. The Case Manager develops a proactive course of… 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
- North Wind Group (Nashville, TN)
- … utilization of staff, reputation of the office, contract management , billing collection and project profitability. The SPM prepares project proposals ... for each project on a weekly basis with Project Manager , Design/Project Engineer, using scheduling and project management...nature of those accommodations will be determined on a case -by- case basis. If you are an individual… more
- Elevance Health (Nashville, TN)
- …and Experiences:** + AS or BS in nursing preferred. + Certification as a Case Manager is preferred. + Participation in the American Association of Managed ... and modifies as necessary. + Assists with development of utilization /care management policies and procedures. + Participates...providing services in multiple states . Certification as a Case Manager or a BS in a… 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. ... Nurse (RN). Preferred Qualifications + Bachelor's degree in Nursing. + Certified Case Manager (CCM). Relevant certification as determined at position level.… more
- GAF (Nashville, TN)
- …this roof, we protect what matters most. **Team Summary** The Maintenance Excellence Manager is a key member of the Corporate Reliability & Maintenance team and ... works closely with corporate peers focusing on Reliability Engineering, Materials Management , and Training pillars. This role will report to the Sr. Director of… more
- Molina Healthcare (Bowling Green, KY)
- …one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case ... through one or more direct report supervisors, facilitates integrated, proactive management , ensuring compliance with state and federal regulatory and accrediting… 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
- Molina Healthcare (Bowling Green, KY)
- …in Clinical Program Evaluation + Experience in building clinical targeting models for Case Management + Experience or strong desire to learn Python/PySpark + ... needs. + Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management . + Interfaces and maintains… 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
- 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