• Clinical Utilization Review

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
    Community Health Systems (10/14/25)
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  • RN Utilization Specialist

    YesCare Corp (Brentwood, TN)
    …+ Assist in completion of special projects on an as needed basis. **Key Qualifications:** + Registered Nurse ( RN ) active license + No less than 5 years' ... lives through care and expertise. **Key Responsibilities:** + The nurse will focus on what's best for the patients...practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. +… more
    YesCare Corp (10/30/25)
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  • Clinical Documentation Specialist

    Houston Methodist (TN)
    …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
    Houston Methodist (10/29/25)
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  • RN Care Mgr II

    Covenant Health Inc. (Knoxville, TN)
    Overview Registered Nurse Care Manager, Continuum of Care Full Time, 80 Hours Per Pay Period , Day Shift M-F. May rotate weekend and minor holidays. Parkwest ... duties. + Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory. +… more
    Covenant Health Inc. (09/03/25)
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  • RN Care Mgr II

    Covenant Health Inc. (Lenoir City, TN)
    Overview Registered Nurse Care Manager, Quality Management PRN/OCC,Hours and Shifts Vary Fort Loudoun Medical Center Overview: Fort Loudoun Medical Center is ... + Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory. Education:… more
    Covenant Health Inc. (09/04/25)
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  • RN Care Coordinator II

    Covenant Health Inc. (Knoxville, TN)
    Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift About Us Covenant Medical Group employs or manages ... duties. + Provides care coordination services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory. + In… more
    Covenant Health Inc. (10/10/25)
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  • RN Care MGR II

    Covenant Health Inc. (Harriman, TN)
    …duties + Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory + In ... Overview RN Care Manager, Continuum of Care PRN/OCC, Variable...that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist more
    Covenant Health Inc. (09/26/25)
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  • RN Care Mgr III

    Covenant Health Inc. (Harriman, TN)
    …requested. + Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory. + In ... Overview RN Care Manager, Continuum of Care PRN/OCC, Variable...that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist more
    Covenant Health Inc. (09/15/25)
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  • Assessment Specialist PRN

    HCA Healthcare (Nashville, TN)
    …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... any other healthcare provider. We are seeking a(an) Assessment Specialist PRN to join our healthcare family. **Benefits** TriStar...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
    HCA Healthcare (09/27/25)
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  • Expanse Clinical Educator

    HCA Healthcare (Nashville, TN)
    …or instruction of Clinical EHR application - Required + Currently licensed as a registered nurse or allied health professional in the state(s) in which he ... join an organization that invests in you as an Expanse Professional Development Specialist ? At HealthTrust, you come first. HCA Healthcare has committed up to $300… more
    HCA Healthcare (09/26/25)
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