- HCA Healthcare (Nashville, TN)
- …of nursing experience required + 1-4 years of relevant case management/ utilization review experience preferred + Registered Nurse - Currently licensed as ... **Introduction** Do you have the career opportunities as a(an) Utilization Review Services RN you...a registered professional nurse in the state in which he or she… more
- Baptist Memorial (Memphis, TN)
- Overview Purpose of Position and Scope of Responsibility Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...clinical experience RN with Case Management or Utilization Review experience in a hospital or… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse , Revenue Integrity & Utilization Management Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health ... payors as applicable. + Completes daily work lists for utilization review meeting the time frames set...word and excel. Licensure Requirements: Current licensure as a Registered Nurse ( RN ) as issued… more
- LifePoint Health (Gallatin, TN)
- Monitors adherence to the hospital's utilization review plan to ensure appropriate use of hospital services, hospital admissions and extended hospitals stays. ... to: Director - Case Management Minimum Education Associate's, Bachelor's degree or RN Diploma in Nursing - Required Required Skills Requires critical thinking… more
- Aveanna Healthcare (Franklin, TN)
- Hospice Registered Nurse RN Full Time ApplyRefer a FriendBack Job Details Requisition #: 204729 Location: Franklin, TN 37064 Category: Nursing Salary: $37.00 ... the plan of care and patient needs. + Participates in quality improvement, utilization review , and infection control activities as requested. + Attends… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to… more
- Covenant Health Inc. (Knoxville, TN)
- …patient liability is correctly managed. + Keeps abreast of current changes affecting Utilization Review as applicable. + Adjusts patient type changes and charges ... Overview Physician Advisor Operations Coordinator, Revenue Integrity and Utilization PRN/OCC, Variable Hours, Day Shift Covenant Health Overview: Covenant Health is… more
- Lebanon Center for Rehabilitation and Healing (Lebanon, TN)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... . 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… more
- Community Health Systems (Antioch, TN)
- …regulatory requirements related to patient care and data privacy. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... and monitors team goals, delegates effectively. + Monitors and ensures effective utilization of equipment and staff within the Transfer Center. + Trains, develops,… more
- Select Medical (Memphis, TN)
- …of Case Management** Position Will Begin In August 2025 **_Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum ... and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan… more
- Fresenius Medical Center (Millington, TN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Sharecare (Nashville, TN)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work ... requests or actions might be indicated * Experience/proficiency in the review and the utilization of EPIC and/or eStar including the Media tab, Care Everywhere,… more
- Veterans Affairs, Veterans Health Administration (Murfreesboro, TN)
- … Nurse -Community Living Center 8A. The Community Living Center (CLC) Registered Nurse ( RN ) executes position responsibilities that: Demonstrate ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities Alvin C. York...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Baptist Memorial (Memphis, TN)
- …and/or life situation. Performs other duties as assigned. Responsibilities + Utilization Review + Discharge planning + Readmission Reduction Participation ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal...Hospital Department: WH Case Management Admin BMH Women's Category: Nurse RN Type: Clinical Work Type: Full… more
- Baptist Memorial (Memphis, TN)
- …and/or life situation. Performs other duties as assigned. Responsibilities + Utilization Review + Discharge planning + Readmission Reduction Participation ... safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer… 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 ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
- Baptist Memorial (Collierville, TN)
- …Preferred/Desired Licensure Minimum Required + License/Certification/Registries (valid for the State of MS): Registered Nurse ( RN ) by the State Board of ... Required. Preferred/Desired + Healthcare/Medical-Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required +… more
- Baptist Memorial (Memphis, TN)
- …Masters in Nursing or related field Minimum: BSN Experience Preferred: Exp with utilization review processes Minimum: Two years of nursing experience in acute ... RN Facility: BMH - Tipton BCC Department: TC BCC Humphreys BCCH Category: Nurse RN Type: Clinical Nurse Work Type: Full Time Work Schedule: Days Location:… more
- Community Health Systems (Powell, TN)
- …Commitment to patient-centered care and continuous quality improvement. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... experience required + 3-5 years of experience in care management or utilization review required + 1-3 years of leadership experience in a healthcare setting… more