- HCA Healthcare (Nashville, TN)
- …of nursing experience required + 1-4 years of relevant case management/ utilization review experience preferred + Registered Nurse - Currently licensed as ... **Introduction** Do you have the career opportunities as a(an) Utilization Review Services RN you...a registered professional nurse in the state in which he or she… more
- Baptist Memorial (Memphis, TN)
- Overview Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and ... treatment as prescribed by utilization review standards. The UR ...clinical experience RN with Case Management or Utilization Review experience in a hospital or… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse , Revenue Integrity & Utilization Management Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health ... payors as applicable. + Completes daily work lists for utilization review meeting the time frames set...word and excel. Licensure Requirements: Current licensure as a Registered Nurse ( RN ) as issued… more
- Vanderbilt University Medical Center (Nashville, TN)
- …that the appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary ... difficulty. * Clinical Applications Systems (Novice): Possesses fundamental proficiency in utilization review systems, clinical support systems and business… more
- Ascension Health (Nashville, TN)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40...all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Tennessee Board… more
- Humana (Clarksville, TN)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... and external customers and stakeholders. **Preferred Qualifications** + Experience with utilization review process. + Experience with behavioral change, health… more
- LifePoint Health (Gallatin, TN)
- Monitors adherence to the hospital's utilization review plan to ensure appropriate use of hospital services, hospital admissions and extended hospitals stays. ... to: Director - Case Management Minimum Education Associate's, Bachelor's degree or RN Diploma in Nursing - Required Required Skills Requires critical thinking… more
- Aveanna Healthcare (Franklin, TN)
- Hospice Registered Nurse RN Full Time ApplyRefer a FriendBack Job Details Requisition #: 204729 Location: Franklin, TN 37064 Category: Nursing Salary: $37.00 ... the plan of care and patient needs. + Participates in quality improvement, utilization review , and infection control activities as requested. + Attends… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to… more
- Covenant Health Inc. (Knoxville, TN)
- …patient liability is correctly managed. + Keeps abreast of current changes affecting Utilization Review as applicable. + Adjusts patient type changes and charges ... Overview Physician Advisor Operations Coordinator, Revenue Integrity and Utilization PRN/OCC, Variable Hours, Day Shift Covenant Health Overview: Covenant Health is… more