• Utilization Review…

    Community Health Systems (Franklin, TN)
    **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities,… more
    Community Health Systems (11/22/25)
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  • Utilization Management Administration…

    Humana (Nashville, TN)
    …new systems (proficient to advanced) **Preferred Qualifications** + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... and help us put health first** The UM Administration Coordinator contributes to administration of utilization management....the nursing team + Builds and pends authorizations for review + Responsible for inbound and outbound calls to… more
    Humana (10/10/25)
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  • SNF Utilization Management RN - Compact Rqd

    Humana (Nashville, TN)
    … or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
    Humana (09/12/25)
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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 ... We're a proud member of Covenant Health! Position Summary: The RN Care Coordinator II is responsible for integrating evidenced based clinical practice into the… more
    Covenant Health Inc. (10/10/25)
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  • UM Coordinator 2 - Weekend Work

    Humana (Nashville, TN)
    …utilizing electronic medical record and documentation programs + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization ...of Medical Terminology and/or ICD-10 codes + Experience with Utilization Review and/or Prior Authorization, preferably within… more
    Humana (11/20/25)
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  • MDS Coordinator

    Manchester Center for Rehabilitation and Healing (Manchester, TN)
    …trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends ... MDS Coordinator Manchester Center for Rehabilitation and Healing is...and Healing is looking for talented and motivated MDS Coordinator to join our dynamic team. The position is… more
    Manchester Center for Rehabilitation and Healing (11/18/25)
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  • MDS Coordinator -Certified

    Covenant Health Inc. (Knoxville, TN)
    Overview Certified MDS Coordinator , Transitional Care PRN/OCC, Variable Hours, Day Shift Fort Sanders Regional Overview: Fort Sanders Regional Medical Center is an ... in a manner that accurately captures the RUG (Resource Utilization Group) category. + Will provide a schedule of...as needed based on timeliness of completion. The MDS Coordinator is expected to report any issues with timely… more
    Covenant Health Inc. (11/12/25)
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  • Case Manager, Registered Nurse - Fully Remote

    CVS Health (Nashville, TN)
    …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (11/19/25)
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  • Respiratory Therapy

    Trevecca Center for Rehabilitation and Healing (Nashville, TN)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... the administrator in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers to achieve budget… more
    Trevecca Center for Rehabilitation and Healing (11/06/25)
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  • Respiratory Registered Nurse

    Lebanon Center for Rehabilitation and Healing (Lebanon, TN)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... the facility with the director of nursing, nurse managers, and admissions coordinator to assist in development of the respiratory therapy program. . Establishing… more
    Lebanon Center for Rehabilitation and Healing (11/22/25)
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