Utilization Management jobs in Nashville, TN

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Utilization Review Case Manager / RN
MedSolutions - Franklin, TN
O 2 – 5 years experience in utilization and case management required. O Certification must be obtained within a 4 year period to continue employment in a Case...
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Sponsored by MedSolutions - 11 days ago
Financial Business Analyst
Direct General Auto Insurance - Nashville, TN
Ability to develop and implement data models through the utilization of relational databases and/or multi-dimensional database tools....
Sponsored by Direct Auto Insurance - 30+ days ago

Telephonic Nurse Case Manager - office based

UnitedHealth Group 1,632 reviews - Franklin, TN
Experience in utilization management, risk management and/or quality management. Case Management certification is a plus....
16 hours ago - save job - email - more...

Team Lead, Transition Management Dept., full-time, days

Vanderbilt University 300 reviews - Nashville, TN
Understands established area budget and adjusts resource utilization to minimize variances. The TL leads a cohort of front line staff members and actively...
5 days ago - save job - email - more...

RN - Clinical Reviewer

Ascend Management Innovations 3 reviews - Franklin, TN
Perform document-based and telephonic utilization reviews for contract services, determining medical necessity for contract-specific Medicaid medical and/or...
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4 days ago - save job - email - more...

Outpatient Nurse Care

WellCare 89 reviews - Brentwood, TN
Determines appropriate utilization management of services requested. 2+ years clinical experience in acute clinical/surgical experience, current experience in...
1 day ago - save job - email - more...

Utilization Management Specialist

NaviHealth - Nashville, TN - +1 location
At least two years recent experience in case-management or utilization management. Collaborates with physicians, clinical staff, management and financial...
27 days ago - save job - email - more...

Quality Review Nurse

Brookdale - Nashville, TN
Supports the efforts of the agency in managing quality of clinical care, utilization, documentation, outcome & process management through education, associate...
6 days ago - save job - email - more...

RN Acute Care Case Manager(Utilization Review Nurse ) Nashvi...

CIGNA 750 reviews - Nashville, TN
Experience in utilization management and/or discharge planning. RN Acute Care Case Manager(Utilization Review Nurse ) Nashville, TN....
14 days ago - save job - email - more...

Asst Mgr, Environmental Svcs 1st Shift

Vanderbilt University 300 reviews - Nashville, TN
Plan work flow and staffing levels to insure quality service, efficient labor utilization, and staffing balance....
3 days ago - save job - email - more...

Utilization Review Nurse

CIGNA 750 reviews - Nashville, TN
Experience in utilization management and/or discharge planning. Utilization Review Nurse. Goal 1 – Appropriate Level of Care Determinations....
14 days ago - save job - email - more...

Utilization Management Review Coordinator Team Lead

NaviHealth - Nashville, TN
At least two years working in a health plan (or equivalent) Utilization Management environment (preferred)....
28 days ago - save job - email - more...
Telephonic Nurse Case Manager - office based
UnitedHealth Group 1,632 reviews - Franklin, TN
Experience in utilization management, risk management and/or quality management. Case Management certification is a plus....
Sponsored by UnitedHealth Group - 16 hours ago
RN - $10k Relocation to Orlando - Progressive Care Unit
Florida Hospital 343 reviews - Nashville, TN
Additional management responsibilities include effective conflict resolution, patient/staff rounding and communication, resource utilization, comprehensive hand...
Sponsored by Florida Hospital - 20 days ago
RN / Case Manager / Utilization Review Nurse
Kelly Services 2,734 reviews - Nashville, TN
Adhere to quality assurance standards and all utilization management policies and procedures. RN / CASE MANAGER / UTILIZATION REVIEW NURSE....
Sponsored by Kelly Services - 2 hours ago

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