Utilization Review Nurse jobs in Tennessee

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RN Oasis Quality Review- Home Health
ContinuCare Health Services - Chattanooga, TN
The OASIS Quality Review Nurse is an RN with a minimum of three years Home Health experience, certified ICD – 9 / ICD-10 Coder and preferably OASIS certified....
Sponsored by ContinuCare Health Services
Clinical Appeals Nurse RN - Telecommute from Tennessee
UnitedHealth Group 2,123 reviews - Brentwood, TN
Previous Utilization Review experience. RN, registered nurse, inpatient case manager, utilization review, utilization management, work from home, telecommute,...
Sponsored by UnitedHealth Group
Senior Clinical Administration Nurse - TN Telecommute
UnitedHealth Group 2,123 reviews - Nashville, TN
RN, nurse, case management, case manager, utilization, medical review, audit, Medicaid, Tenncare, CMS, NCQA, quality, TN, telecommute, bilingual, Spanish....
Sponsored by UnitedHealth Group

Utilization Review Nurse- RN Required

CES, LLC - Nashville, TN
Utilization/ quality review and coding expereince:. LEAD CLAIMS REVIEW ANALYST. Previous Medicare Medical Review experience is preferred....
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Medical Case Manager

BlueCross BlueShield of Tennessee 45 reviews - Chattanooga, TN
Assess resource utilization and cost management; Prefer two (2) years experience in Utilization Management, Case Management or Managed Care....

Review Analyst - Multiple Openings

BlueCross BlueShield of Tennessee 45 reviews - Chattanooga, TN
Review Analyst - Multiple Openings. Performs prospective and retrospective medical necessity reviews....

Clinical Appeals Nurse RN - Telecommute from Tennessee

UnitedHealth Group 2,123 reviews - Brentwood, TN
Previous Utilization Review experience. RN, registered nurse, inpatient case manager, utilization review, utilization management, work from home, telecommute,...

BPCI RN Case Manager

eviCore healthcare - Franklin, TN
Utilization Management Nurse Reviewer —Post Acute Care. The Utilization Management Nurse Reviewer will conduct clinical review to determine medical necessity of...

Director, Medical Necessity Review

Corporate Parallon - Franklin, TN
Registered Nurse, Nurse Practitioner, Physician Assistant. In Nursing, Physician Assistant, Nurse Practitioner or equivalent clinical expertise....

RN Medical Case Mgr Workers' Compensation

The Travelers Companies, Inc. 3 reviews - Franklin, TN
For nurses handling Workers Compensation Claims, perform Utilization Review according to established guidelines....

Senior Clinical Administration Nurse - TN Telecommute

UnitedHealth Group 2,123 reviews - Nashville, TN
RN, nurse, case management, case manager, utilization, medical review, audit, Medicaid, Tenncare, CMS, NCQA, quality, TN, telecommute, bilingual, Spanish....

Medicare Medical Review RN

NCI Information Systems, Inc. 133 reviews - Nashville, TN
As the Medical Review Nurse ( Medical Reviewer ), you are responsible for conducting clinical reviews of medical records during the course of fraud...

Transition of Care Nurse

BlueCross BlueShield of Tennessee 45 reviews - Chattanooga, TN
3 years of utilization review or case management experience preferred. Transition of Care Nurse. Assess resource utilization and cost management;...
Statewide Health Services Director - Brentwood, TN-Must Repo...
UnitedHealth Group 2,123 reviews - Brentwood, TN
Leadership (Measured through performance metrics, Colleague Reviews, NCQA Accreditation, if applicable). Conducts local clinical documentation reviews and...
Sponsored by UnitedHealth Group
Senior Consultant - Healthcare Coding
FTI Consulting, Inc. - Nashville, TN
Registered Nurse (RN). Responsible for ICD—9/10 record review as well as auditing, ICD-9 and ICD-10. The work may also entail identification of cost efficiency...
Sponsored by FTI Consulting, Inc.

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