- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
- Community Health Systems (Franklin, TN)
- …information to secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and ... **Job Summary** The Utilization Review Coordinator ensures efficient and...activities. This role collaborates with payers, hospital staff, and clinical specialists to secure timely authorizations for hospital admissions… more
- Deloitte (Nashville, TN)
- …registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk… more
- HCA Healthcare (Nashville, TN)
- …join an organization that invests in you as a(an) Expanse Professional Development Specialist ? At HealthTrust, you come first. HCA Healthcare has committed up to ... We are looking for a dedicated Expanse Professional Development Specialist like you to be a part of our...includes the educational aspects of orientation and onboarding of clinical employees and development of education that addresses EHR… more
- Houston Methodist (TN)
- …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year ... At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the overall quality and completeness of clinical documentation. This… more
- Vanderbilt University Medical Center (Nashville, TN)
- …monitoring plan to meet the individualized drug therapy needs of the patient. The clinical specialist is responsible for leading efforts in the prevention and ... of medication therapy. . **Vanderbilt Health** is hiring an **Outpatient Oncology Clinical Pharmacist Specialist ** at **The Vanderbilt Clinic** ! **Position… more
- HCA Healthcare (Nashville, TN)
- …do. We want you to apply! **Job Summary and Qualifications** The Impatient Authorization Review Specialist will review post discharge, prebill accounts that ... vary by location._** We are seeking an Inpatient Authorization Review Services Specialist for our team to...denied by the payor that do not require a clinical review . Communicate with third party payors… more
- HCA Healthcare (Nashville, TN)
- …face or telemedicine assessment completed and physician consult. + Provides a thorough clinical review and risk assessment with appropriate level of care ... treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile… more
- Oracle (Nashville, TN)
- …stays. + Knowledge of third-party payor rules and regulations. + 2-3 years of Utilization Review experience in a healthcare setting preferred; 1-2 years of ... college and AHIMA Certified RHIT credentials preferred + Certification in Utilization Review , case management, and healthcare quality preferred… more
- HCA Healthcare (Nashville, TN)
- …operations, policies, systems and procedures necessary to support cost reduction and system utilization goals. + Provide monthly KPI's for review and regular ... Do you want to join an organization that invests in you as a Sr Specialist Workforce Planning and Integration? At HCA Healthcare, you come first. HCA Healthcare has… more