Utilization Management jobs in Nashville, TN

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Director of Case Management - $8000 Sign-On
, you will assume responsibility for the overall functions and professional growth of the Department including yet not limited to Utilization Review (UR) and...
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Systems Analytics, Management and Monitoring Engineer
PREMISE HEALTH - 68 reviews - Brentwood, TN 37027
Infrastructure utilization and capacity analysis. Experience in Systems Monitoring & Management Engineer role....
Provider Enrollment Specialist - FT
Outpatient Imaging Affiliates - Franklin, TN 37067
Knowledge of claims administration, network development, provider contracting, credentialing, customer service and utilization management functions....
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Registered Nurse (RN)--Utilization Review

Centennial Medical Center - 100 reviews - Nashville, TN
Utilization Review Nurse--PRN. The Utilization Review Nurse performs medical necessity reviews on all commercial payor admissions to obtain authorization for...

Inpatient Care Nurse - Telephonic

WellCare - 716 reviews - Brentwood, TN 37027
Oversees the appropriate utilization management of services requested. HEALTH SERVICES-INPATIENT CARE MANAGEMENT....

Clinical (RN req'd) Quality Auditor Sr, Behavioral Health -...

Anthem, Inc. - 2,299 reviews - Nashville, TN
5 years of experience in utilization management, quality assurance and/or plan administration or any combination of education and experience, which would...

Onsite RN Liaison

UnitedHealth Group - 5,930 reviews - Nashville, TN 37214  +1 location
Wellness, Disease Management and Care Management. 3+ years care management. Monitors and analyzes medical management activities....

Nurse Auditor

Advent Health Partners - 3 reviews - Nashville, TN
Case Management and/or Utilization Review experience a plus. Performs medical necessity reviews of clinical documentation to determine the appropriateness of in...

Clinical Transformation Consultant

UnitedHealth Group - 5,930 reviews - Nashville, TN 37214
The Clinical Transformation Consultant (CTC) is responsible for the ongoing clinical management of physician practices participating in UnitedHealthcare’s (UHC)...

Utilization Review Associate / Metro Center / PT Days

Saint Thomas, TN - 23 reviews - Nashville, TN
Utilization Review Associate. Utilization Review Associate / Metro Center / PT Days. Acts as a resource for on-site care management team and physicians....

Mgr Clinical Care Team/FT/Day

Ascension (System Office) - Nashville, TN
Care Management Nashville. Ascension's Healthcare Division operates 2,500 sites of care – including 141 hospitals and more than 30 senior living facilities – in...

Utilization Management Specialist (Part-Time-Flex Schedule)

Vanderbilt University Medical Center - 116 reviews - Nashville, TN 37232
Utilization Management Specialist, RN/LPN (Part-Time-Flex Schedule). Utilization Specialist (UMS). Care Coordination/Transition Management Office....

Utilization Review Associate / Metro Center / FT Days

Saint Thomas, TN - 23 reviews - Nashville, TN
Utilization Review Associate. Utilization Review Associate / Metro Center / FT Days. Acts as a resource for on-site care management team and physicians....
Lifestyle Coach (Program Manager)
MillarRich - 6 reviews - Nashville, TN 37218
$35,000 a year
Checking Therap documentation throughout the week as well as monitoring the data entered by the Family Lifestyle Teachers to ensure compliance of other...
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Registered Nurse (RN)--Utilization Review
Utilization Review Nurse--PRN. The Utilization Review Nurse performs medical necessity reviews on all commercial payor admissions to obtain authorization for...

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