• PRN Clinical Utilization

    Community Health Systems (Franklin, TN)
    **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital … more
    Community Health Systems (12/03/25)
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  • PRN Director Clinical Resource…

    HCA Healthcare (Nashville, TN)
    …**Introduction** Do you want to join an organization that invests in you as a PRN Director Clinical Resource Management? At HealthTrust, a division of HCA, you ... make a difference. We are looking for a dedicated PRN Director Clinical Resource Management like you...and optimizing the current GPO contract portfolio, developing comprehensive clinical and utilization protocols, and developing and… more
    HCA Healthcare (12/03/25)
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  • Assessment Specialist PRN

    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
    HCA Healthcare (11/10/25)
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  • PRN Director Pharmacy Solutions

    HCA Healthcare (Nashville, TN)
    …**Introduction** Do you want to join an organization that invests in you as a PRN Director Pharmacy Solutions? At HealthTrust, a division of HCA, you come first. HCA ... make a difference. We are looking for a dedicated PRN Director Pharmacy Solutions like you to be a...Pharmacy (eg CPO, VP, DOP) Leaders, Pharmacy Leaders (eg clinical , operational), Physicians, Value Analysis Leaders, HealthTrust Contracting Team.… more
    HCA Healthcare (01/09/26)
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  • RN Utilization Mgmt I

    Covenant Health Inc. (Knoxville, TN)
    …meetings between physicians and payors as applicable. + Completes daily work lists for utilization review meeting the time frames set forth by Covenant Health. + ... Overview Registered Nurse Utilization Management PRN /OCC,Hours Vary, Day Shifts...utilization management. + Provides monitoring and oversight of non- clinical utilization staff activities. + Provides advice… more
    Covenant Health Inc. (12/18/25)
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  • Registered Nurse Discharge Planner, Peds Case…

    Vanderbilt University Medical Center (Nashville, TN)
    …continuum of care. Conducts initial and/or concurrent utilization review medical necessity criteria. ... key Pillar outcomes and system improvement goals including financial, satisfaction, and clinical as the nursing component of the care coordination model. Assists in… more
    Vanderbilt University Medical Center (01/07/26)
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  • Regional Care Manager (Midwest or Eastern Region)

    Wellpath (Franklin, TN)
    …you make a difference** The Regional Care Manager (RCM) is responsible for utilization review , care coordination, and daily care management across multiple sites ... Nursing or Care Management Certification + RN preferred EXPERIENCE + Previous utilization review and/or case management and pre-certification experience +… more
    Wellpath (12/25/25)
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  • RN Care Mgr II

    Covenant Health Inc. (Sevierville, TN)
    …the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist, as necessary ... Overview Registered Nurse Care Manager, Continuum of Care PRN , Variable Hours & Shift LeConte Medical Center...Care Manager II is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education… more
    Covenant Health Inc. (01/07/26)
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  • RN Care MGR II

    Covenant Health Inc. (Harriman, TN)
    …the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist, as necessary ... Overview RN Care Manager, Continuum of Care PRN /OCC, Variable Hours & Shifts Roane Medical Center...Care Manager II is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education… more
    Covenant Health Inc. (12/26/25)
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  • RN Care Mgr III

    Covenant Health Inc. (Harriman, TN)
    …for the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist + As ... Overview RN Care Manager, Continuum of Care PRN /OCC, Variable Hours, Day Shift Roane Medical Center...Care Manager III is responsible for integrating evidenced based clinical practice into the patient care setting, coordinating education… more
    Covenant Health Inc. (12/14/25)
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