- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a(an) Utilization Review Services RN you want with your current employer? We ... of colleagues. Do you want to work as a(an) Utilization Review Services RN...+ 1-4 years of relevant case management/ utilization review experience preferred + Registered Nurse… more
- Baptist Memorial (Memphis, TN)
- …necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, ... Overview Job Summary The Utilization Review Nurse is...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
- Vanderbilt University Medical Center (Nashville, TN)
- …that the appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary ... difficulty. * Clinical Applications Systems (Novice): Possesses fundamental proficiency in utilization review systems, clinical support systems and business… more
- Humana (Clarksville, TN)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... and external customers and stakeholders. **Preferred Qualifications** + Experience with utilization review process. + Experience with behavioral change, health… 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 ... 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...for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management… 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 ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a...and clinical code of ethics and practice. . Implementing in- services and training. . Maintaining a current body of… more
- Veterans Affairs, Veterans Health Administration (Nashville, TN)
- …located in Nashville, TN. Responsibilities The Nurse Referral Coordination Team (RCT) Registered Nurse ( RN )) is responsible for executing a streamlined ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation...Request for Services (RFS) to promote inhouse service access. The RCT RN will utilize… 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 ... growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge...in order to ensure proper reimbursement for hospital provided services and to promote cost attentive care via a… more
- Fresenius Medical Center (Winchester, TN)
- …direct reports. + Partners with internal Human Resources, Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program ... auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic… 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 ... if additional records requests or actions might be indicated * Experience/proficiency in the review and the utilization of EPIC and/or eStar including the Media… more
- HCA Healthcare (Nashville, TN)
- …Surgery Center have the opportunity to make a real impact. As an Operating Room Registered Nurse you can be a part of change. **Benefits** Centennial Surgery ... include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay....positive outcomes for your patients as an Operating Room Registered Nurse . We want your knowledge and… 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...Hospital Department: WH Case Management Admin BMH Women's Category: Nurse RN Type: Clinical Work Type: Full… 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 ... Summary This role supports care coordination activities within ambulatory services ; specifically for the medical group. Performs all duties...- Tipton BCC Department: TC BCC Humphreys BCCH Category: Nurse RN Type: Clinical Nurse … 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 ... to evaluate severity of illness (SI) and intensity of services (IS) for admissions, continued stays, and discharge planning....+ 3-5 years of experience in care management or utilization review required + 1-3 years of… more