- BlueCross BlueShield of Tennessee (Nashville, TN)
- …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... sickle cell, brain injuries, oncology\-related needs\)\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... meet their complex needs\. As a Care Transition Case Manager , you will play a vital role in ensuring...have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and… more
- Fresenius Medical Center (Madisonville, KY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... current licensure in a clinical discipline either as a Nurse ( RN /LPN/LVN) or a Respiratory Therapist (RT)...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Select Medical (Nashville, TN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates...**Current licensure in a clinical discipline either as a Nurse ( RN /LPN/ LVN)or a Respiratory Therapist… more
- CenterWell (Nashville, TN)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- Elevance Health (Nashville, TN)
- …I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient ... provide an equivalent background. + Current active unrestricted license, such as ** RN LCSW** **LMSW LMHC** **LPC** (as allowed by applicable state laws) **LMFT**… more
- HCA Healthcare (Nashville, TN)
- …Centennial Medical Center have the opportunity to make a real impact. As a(an) Case Manager RN you can be a part of change. **Benefits** TriStar Centennial ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...positive outcomes for your patients as a (an) Case Manager RN . We want your knowledge and… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the PRN career opportunities as a(an) Case Manager RN PRN you want with your current employer? We have an exciting ... colleagues. Do you want to work as a(an) Case Manager RN PRN where your passion for...stay, managing the length of stay, ensuring appropriate resource management and developing a safe appropriate discharge plan in… more
- Humana (Nashville, TN)
- …concerns.** **Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse ( RN ) Multi-state/Compact State license with no ... caring community and help us put health first** The Nurse Advice Line is a fast-paced inbound call center...care, skilled or rehabilitation setting, home health, DME, triage, utilization , or case management . + **Ability to… more
- Community Health Systems (Clarksville, TN)
- …platforms, healthcare software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **Job Summary** The Supervisor, House - RN provides critical leadership during assigned shifts to...coordinates admissions, discharges, and transfers, and ensures optimal bed utilization . + Acts as the administrative point of contact… more
- Elevance Health (Clarksville, TN)
- …unless an accommodation is granted as required by law._ The **LTSS Service Coordinator- RN ** is responsible for overall management of member's case within the ... **LTSS Service Coordinator - RN ** **Location:** The location for this position includes Knox, Anderson, Claiborne, Williamson, Davidson, Montgomery, Shelby, Tipton,… more
- Sharecare (Nashville, TN)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... program intervention guidelines. A Disease Management Nurse is supervised by an Operations Manager ...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Deloitte (Nashville, TN)
- …as clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN , ... Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical… more
- Elevance Health (Nashville, TN)
- …unless an accommodation is granted as required by law. The ** Nurse Case Manager I** I is responsible for care management within the scope of licensure ... ** Nurse Case Manager II** **Work Schedule**...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- STG International (Hopkinsville, KY)
- …the management /coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's ... to ensure compliance and patient safety. * Participates in quality improvement, care management , risk management , peer review, utilization review, clinical… more
- Elevance Health (Nashville, TN)
- **Medical Management Nurse ** **Hours: 8am-6pm flexible start time** **Location** : This role enables associates to work virtually full-time, with the exception ... accommodation is granted as required by law. The **Medical Management Nurse ** is responsible for review of...in multiple states. **Preferred Skills, Capabilities & Experiences:** + Utilization management experience. + Strong of computer… more
- Elevance Health (Nashville, TN)
- …Coordinator-Clinician** is responsible for working under the direction/supervision of an RN , with overall responsibility for the member's case. As required by ... the scope of licensure including, for example, assisting the responsible RN with telephonic or face-to-face assessments for the identification, evaluation,… more
- Highmark Health (Nashville, TN)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- CenterWell (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license ( RN )...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
