• Registered Nurse - Clinical…

    Cognizant (Nashville, TN)
    …need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
    Cognizant (10/09/25)
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  • Clinical Review Manager

    BlueCross BlueShield of Tennessee (Chattanooga, TN)
    …month commitment before posting for other internal positions\. **Job Qualifications** _License_ + Registered Nurse \(RN\) with active license in the state of ... retrospective claim review, special review requests, and UM pre\-certifications and appeals , utilizing medical appropriateness criteria, clinical judgement, and… more
    BlueCross BlueShield of Tennessee (10/07/25)
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  • PRN UR Clinical Specialist

    Community Health Systems (Franklin, TN)
    …regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating...conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate… more
    Community Health Systems (09/18/25)
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