Utilization Review Nurse jobs in Nashville, TN

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Registered Nurse (RN)--Utilization Review
Utilization Review Nurse. Utilization Review Nurse--PRN. The Utilization Review Nurse performs medical necessity reviews on all commercial payor admissions to...
Utilization Review Registered Nurse (RN) Case Manager
Working knowledge of reimbursement issues (managed care, utilization review, etc.). Completes reviews on all non-Medicare patients, utilizing InterQual criteria...
Inpatient Care Nurse - Telephonic
Wellcare - 718 reviews - Brentwood, TN 37027
2 years of experience in a clinical setting with general nursing exposure in utilization management to include pre-authorization, utilization review, concurrent...

Medical Review Nurse (TN) - Home-based - Nationwide Openings

Quality Health Strategies - 9 reviews - Nashville, TN
The Medical Review Nurse - Claims Analyst is a mid-level professional performing medical record and claims review for Medicare, Medicaid, and/or other claims...
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Nurse Auditor

Advent Health Partners - 3 reviews - Nashville, TN
Case Management and/or Utilization Review experience a plus. 2-5 years of auditing or medical review experience....

Remote Medical Review RN - Part B/DME - Casual Status

NCI Information Systems, Inc. - 186 reviews - Nashville, TN
Advanced Knowledge of utilization review/ quality assurance procedures. As a Remote Medical Review RN - Part B/DME - Casual Status ( Medical Reviewer III )...

Licensed Utilization Review II (Call Center Nurse)

Anthem, Inc. - 2,302 reviews - Nashville, TN
2 years of acute care or utilization review experience; Review of claim edits, pre-noted inpatient admissions or, episodic outpatient therapy such as physical...

Associate Clinical Account Representative – Nashville, TN -...

Johnson & Johnson Family of Companies - 2,267 reviews - Nashville, TN
Clinical utilization of commercialized Acclarent products and services into. But not limited to physicians, nurses and technicians, clinical and hospital....

Utilization Review Associate / Metro Center / FT Days

Saint Thomas, TN - 23 reviews - Nashville, TN
Utilization Review Associate. Utilization Review Associate / Metro Center / FT Days. Collects information pertinent to the organization's performance and...

Registered Nurse (RN)--Utilization Review

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

Inpatient Care Nurse - Telephonic

WellCare - 718 reviews - Brentwood, TN 37027
2 years of experience in a clinical setting with general nursing exposure in utilization management to include pre-authorization, utilization review, concurrent...

Utilization Review Associate / Metro Center / PT Days

Saint Thomas, TN - 23 reviews - Nashville, TN
Utilization Review Associate. Utilization Review Associate / Metro Center / PT Days. Collects information pertinent to the organization's performance and...

Medical Review Supervisor

NCI Information Systems, Inc. - 186 reviews - Nashville, TN
Assesses results of post-pay reviews conducted by Medical Review Nurses and ensures coordination of workflow between PI and MR staff as needed....
Nurse Auditor
Case Management and/or Utilization Review experience a plus. 2-5 years of auditing or medical review experience....
Utilization Review Nurse
Utilization Review Nurse. We are seeking several regionally-based UM Nurses focusing on outpatient utilization management nursing....

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