• 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)
    - Related Jobs
  • PRN Utilization Review

    Community Health Systems (Franklin, TN)
    …to secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist. + Monitors and updates case ... **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
    Community Health Systems (11/15/25)
    - Related Jobs
  • 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)
    - Related Jobs
  • 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)
    - Related Jobs
  • 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 (10/10/25)
    - Related Jobs
  • Denials Prevention Specialist, Clinician…

    Datavant (Nashville, TN)
    …healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... recognized medical necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed… more
    Datavant (11/12/25)
    - Related Jobs
  • Regional Care Manager - Must be Located in…

    Wellpath (Franklin, TN)
    …support. **About this role** The Regional Care Manager (RCM) is responsible for utilization review , care coordination, and daily care management across multiple ... Nursing or Care Management Certification + RN preferred EXPERIENCE + Previous utilization review and/or case management and pre-certification experience +… more
    Wellpath (11/15/25)
    - Related Jobs
  • 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. (09/26/25)
    - Related Jobs
  • 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. (09/15/25)
    - Related Jobs
  • RN Care Mgr II

    Covenant Health Inc. (Lenoir City, 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, Quality Management PRN /OCC,Hours and Shifts Vary Fort Loudoun Medical Center Overview: Fort Loudoun Medical Center is… more
    Covenant Health Inc. (09/04/25)
    - Related Jobs