- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Utilization Review Services RN you want with your current employer? We have an ... of colleagues. Do you want to work as a Utilization Review Services RN...- 4 years of relevant case management/ utilization review experience preferred + Registered Nurse… more
- Baptist Memorial (Memphis, TN)
- …necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, ... of Position and Scope of Responsibility Job Summary The Utilization Review Nurse is responsible...clinical experience RN with Case Management or Utilization Review experience in a hospital or… more
- Baptist Memorial (Memphis, TN)
- …and/or life situation. Performs other duties as assigned. Responsibilities + Utilization Review + Discharge planning + Readmission Reduction Participation ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance...+ Completes assigned goals. Specifications Experience Minimum Required + RN with at least one (1) year of clinical… more
- CVS Health (Nashville, TN)
- …to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN licensure in ... care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and… 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...for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management… more
- CVS Health (Nashville, TN)
- …care - Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience in ... a hospital setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
- CVS Health (Nashville, TN)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… 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
- CenterWell (Kingsport, TN)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- 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 ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a...and clinical code of ethics and practice. . Implementing in- services and training. . Maintaining a current body of… more