Utilization Review Nurse jobs in Tennessee

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RN / Case Manager / Utilization Review Nurse
Kelly Services 2,736 reviews - Nashville, TN
RN / CASE MANAGER / UTILIZATION REVIEW NURSE. As the RN / Case Manager / Utilization Review Nurse with a global health insurance service company, you’ll be...
Sponsored by Kelly Services - 1 day ago
Utilization Review Case Manager / RN
MedSolutions - Franklin, TN
Performs utilization review activities for Post Acute Care requests and contacts providers where additional information is necessary to make a decision....
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Sponsored by MedSolutions - 12 days ago

RN Review Analyst

BlueCross BlueShield of Tennessee 34 reviews - Chattanooga, TN
Performs prospective and retrospective medical necessity reviews. Utilizes the following systems applications when performing comprehensive reviews:....
14 hours ago - save job - email - more...

Utilization Mgt Specialist, Registered Nurse

Vanderbilt University 300 reviews - Nashville, TN
Conduct concurrent admission and continued stay reviews based on utilization review criteria. Refer and consult with the case manager and social worker to...
13 days ago - save job - email - more...

Audit Nurse-RN/LPN-Davidson County

Home Health Care of Middle TN 2 reviews - Nashville, TN
A Registered Nurse (RN) or a Licensed Practical (LPN) Nurse, licensed in the state of Tennessee. 1-2 years of utilization review/quality improvement experience...
5 days ago - save job - email - more...

Medicare Medical Review RN

NCI Information Systems, Inc. 107 reviews - Nashville, TN
As the Medicare Medical Review Nurse ( Medical Reviewer III ), you will primarily be responsible for conducting clinical reviews of medical records during the...
9 days ago - save job - email - more...

Outpatient Nurse Care

WellCare 89 reviews - Brentwood, TN
2+ years clinical experience in acute clinical/surgical experience, current experience in utilization management to include pre-authorization, utilization...
2 days ago - save job - email - more...

Nurse Utilization Management - Inpatient

WellPoint, Inc 478 reviews - Nashville, TN
Nurse Medical Management I (Inpatient) - Nashville, TN. Conducts pre-certification, inpatient, retrospective, out of network and appropriateness of treatment...
WellPoint - 13 days ago - save job - email - more...

Lead Medicare Claims Reviewer (RN)

Catapult Consultants - Nashville, TN
Must be a Graduate from an accredited school of nursing and has an active license as a Registered Nurse (RN) or Licensed Practical Nurse (LPN)....
30+ days ago - save job - email - more...

Telephonic and Field Based Health First Steps RN Case Manage...

UnitedHealth Group 1,632 reviews - Nashville, TN
Experience in utilization review, concurrent review and/or risk management. Antepartum, Labor and Delivery, post partum, nurse, RN, case maangement, Brentwood,...
19 days ago - save job - email - more...

RN Case Manager Trauma Full Time

Erlanger Health System 15 reviews - Chattanooga, TN
Experience preferred in both utilization management and case management. Manages timely and appropriate use of BEH resources through ongoing review of hospital...
5 days ago - save job - email - more...

Nursing Supervisor

Vanguard Healthcare Services - Murfreesboro, TN - +3 locations
Periodically review the resident’s written discharge plan. Assist the Nurse Educator in developing and presenting in-service programs....
2 days ago - save job - email - more...
Clinical Support Specialist
MedSolutions - Franklin, TN
Completing data entry of demographics, requested service, insurance information, and basic clinical information into the information system and assigning the...
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Sponsored by MedSolutions - 22 days ago
Medicare Medical Review Supervisor
NCI Information Systems, Inc. 107 reviews - Nashville, TN
Assess results of post-pay reviews conducted by Medical Review Nurses and ensure the coordination of workflow between PI and MR staff as needed....
Sponsored by NCI Information Systems, Inc. - 28 days ago
Medical Review Nurse
NCI Information Systems, Inc. 107 reviews - Nashville, TN
Minimum of 2 years experience of working in a skilled nursing facility or SNF medical record utilization review....
Sponsored by NCI Information Systems, Inc. - 30+ days ago

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