Utilization Review RN jobs in Nashville, TN

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Licensed Utilization Review II (Call Center Nurse)-Nashville...
Anthem, Inc. - 2,464 reviews - Nashville, TN 37201
2 years of acute care or utilization review experience; Requires an LPN, LVN, or RN; Review of claim edits, pre-noted inpatient admissions or, episodic...
Nurse Liaison, Registered Nurse- Sign-on Bonus offered!!
RN. RN experience required. Valid Tennessee RN license; Review ER utilization and work with team nurses to develop a plan on frequent ER utilizers....
Easily apply
Care Coordinator-UM (RN or LPN)
2 – 4 years’ experience in utilization management required. The Registered Nurse or Licensed Practical Nurse will perform clinical and operational processes...

RN Medical Reviewer III

CGS Administrators - 25 reviews - Nashville, TN
Provides support and review of medical claims and utilization practices. Administrative experience in utilization review, health care quality assurance, medical...

Telephonic Case Manager

UnitedHealth Group - 9,630 reviews - Nashville, TN 37214
Experience in utilization review, concurrent review or risk management. Current, unrestricted RN license in the state of employment....

UR COORDINATOR

Universal Health Services - 238 reviews - Franklin, TN 37067
The Utilization Management Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning....

Nurse Case Manager

Cigna - 2,603 reviews - Nashville, TN
RN and current unrestricted nursing license required. Provides clinical assessments, health education, and utilization management to members....

Licensed Utilization Review II (Call Center Nurse)-Nashville...

Anthem, Inc. - 2,464 reviews - Nashville, TN 37201
2 years of acute care or utilization review experience; Requires an LPN, LVN, or RN; Review of claim edits, pre-noted inpatient admissions or, episodic...

RN Training and Quality Assurance Coordinator

CGS Administrators - 25 reviews - Nashville, TN
Four years of a combination of clinical, utilization review, training, quality assurance or case management experience....

RN Utilization Review Supervisor - Onsite/Nashville

Cigna - 2,603 reviews - Nashville, TN
Current RN licensure required. Experience in Utilization Management, Case Management, or Call Center environment....

Appeals Nurse Coordinator

Xsolis - Nashville, TN
Case Management and/or Utilization Review experience a must. An active RN license in good standing. 2+ years of auditing or medical review experience....

Nurse Consultant Utilization Review

Gallagher - 479 reviews - Franklin, TN
Experience in Worker's Compensation or Utilization Review. Provides utilization management review of worker's compensation claims ....

Registered Nurse-Utilization Review (PRN)

Vanderbilt University Medical Center - 159 reviews - Nashville, TN 37232
Utilization Review Specialist (RN) PRN. You will also conduct initial admission based on utilization review medical necessity criteria;...
RN Supervisor
Blakeford at Green Hills - 4 reviews - Nashville, TN 37215
Review resident care plans for appropriate resident goals, problems, approaches and revisions based on nursing needs....
Easily apply
Registered Nurse (RN) Inpatient Case Manager
Working knowledge of reimbursement issues (managed care, utilization review, etc.). Current Tennessee RN licensure....