- Humana (Nashville, TN)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Nashville, TN)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Elevance Health (Nashville, TN)
- **Medical Management Nurse ** **Hours: 8am-5pm EST** **Location** : This role enables associates to work virtually full-time, with the exception of required ... 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
- Sharecare (Nashville, TN)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… 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 ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Elevance Health (Nashville, TN)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... ** Nurse Case Manager II** **Work Schedule** **: M-F... Case Manager I** I is responsible for care management within the scope of licensure for members with… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …taking vital signs, starting IV and drawing blood, vaginal exams, pain management and obtaining pertinent information and able to document in McKesson/OB Trace ... of care set by state board of nursing, state nurse practice act, and other governing agency regulations. Resolving...care Delegates duties based on complexity of patient needs Utilization of critical thinking skills in prioritization of care… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …by obtaining vital signs, providing personal care items and room orientation. Utilization of critical thinking skills in prioritization of care. Ability to identify ... and copying of all paperwork. Coordinates with nursing supervisor and/or materials management for supply items that cannot be obtained from the Pyxis. Ensures… more
- Vanderbilt University Medical Center (Nashville, TN)
- …to impact pediatric patients and families from the beginning - Autonomy and Utilization of Critical Skills - Teamwork that displays comradery and family center care ... * Analyzes comprehensive information pertinent to the patient's care and management to determine nursing diagnosis. * Continually utilizes the nursing process… more
- Nashville Center for Rehabilitation and Healing (Nashville, TN)
- …team. The RN/LPN Supervisor assumes primary nursing responsibilities for the management of resident and staff activities. The RN/LPN Supervisor utilizes nursing ... practice and management skills and ensures resident care is administered in...nursing care is delivered which is outcome focused through utilization of the nursing process. Identify needs and provide… more
- Fresenius Medical Center (Madisonville, KY)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- HCA Healthcare (Nashville, TN)
- …want to join an organization that invests in you as a Director Case Management ? At TriStar Skyline Medical Center, you come first. HCA Healthcare has committed up ... difference. We are looking for a dedicated Director Case Management like you to be a part of our...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of… more
- Select Medical (Nashville, TN)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Select Medical (Nashville, TN)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- HCA Healthcare (Nashville, TN)
- …required (LPC, LMFT, LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with required DSM V-R ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...reimbursed by contacting managed care organizations and completing initial utilization review. Documents in Midas as required. Involves mobile… more