• Utilization Management Nurse

    Humana (Nashville, TN)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
    Humana (09/12/25)
    - Related Jobs
  • Utilization Management Nurse

    Humana (Nashville, TN)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (11/16/25)
    - Related Jobs
  • Utilization Management Nurse

    CenterWell (Nashville, TN)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (11/22/25)
    - Related Jobs
  • SNF Utilization Management RN…

    Humana (Nashville, TN)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
    - Related Jobs
  • Disease Management Nurse - Remote

    Sharecare (Nashville, TN)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
    Sharecare (10/22/25)
    - Related Jobs
  • Case Manager, Registered Nurse - Fully…

    CVS Health (Nashville, TN)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (11/19/25)
    - Related Jobs
  • Clinical Reviewer, Nurse

    Evolent (Nashville, TN)
    …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
    Evolent (11/20/25)
    - Related Jobs
  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Winchester, TN)
    …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
    Fresenius Medical Center (10/28/25)
    - Related Jobs
  • Night Shift Nurse Supervisor

    Nashville Center for Rehabilitation and Healing (Nashville, TN)
    …team. The RN/LPN Supervisor assumes primary nursing responsibilities for the management of resident and staff activities. The RN/LPN Supervisor utilizes nursing ... practice and management skills and ensures resident care is administered in...nursing care is delivered which is outcome focused through utilization of the nursing process. Identify needs and provide… more
    Nashville Center for Rehabilitation and Healing (10/24/25)
    - Related Jobs
  • Director Case Management

    HCA Healthcare (Hendersonville, TN)
    …to join an organization that invests in you as a(an) Director Case Management ? At TriStar Hendersonville Medical Center, you come first. HCA Healthcare has committed ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
    HCA Healthcare (11/19/25)
    - Related Jobs