utilization review jobs in Nashville, TN

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Case Manager / Utilization Review Nurse
XSOLIS - Nashville, TN
Case Management and/or Utilization Review experience a plus. 2+ years of auditing or medical review experience....
Home Health RN Manager of Clinical Practice $3,000 Sign On B...
Kindred At Home - 98 reviews - Nashville, TN 37211
Be accountable for budget goals through fiscal responsibility, utilization, documentation, providing appropriate and accurate patient care, case mix weight, and...
Implementation Specialist
XSOLIS - Nashville, TN
Monitor client utilization and acceptance rates to identify patterns/trends. Identify opportunities for product penetration of existing accounts and strategies...

Behavioral Health Care Advocate

UnitedHealth Group - 5,204 reviews - Brentwood, TN 37027
As a Behavioral / Mental Health Care Advocate you will be responsible for case management and utilization review of behavioral health and substance abuse cases....

Regional User Access Manager - Work From Home

HCA Corporate - 962 reviews - Nashville, TN
Maximizes utilization of UIP (User Identity Portal) and other enterprise tools. The Regional Access Manager also reviews best practices, standards, and...

Utilization Review Nurse

Catapult Consultants, LLC - 8 reviews - Nashville, TN
2 years utilization/quality assurance review. 5 years clinical experience or equivalent experience in the medical review field....


Rolling Hills Hospital - 19 reviews - Franklin, TN
Experienced Utilization Management Coordinator to. Coordinate and monitor appropriate utilization of services throughout....

Case Manager / Utilization Review Nurse

XSolis - Nashville, TN
An active RN license in good standing3 -5 years of clinical practice 2+ years of auditing or medical review experience Case Management and/or Utilization Review...
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VP - Field Clinical Operations

Cardinal Health - 1,762 reviews - Brentwood, TN 37027
Extensive Utilization Management experience. Review and provide insight to media activities, publications, thought leadership events, press releases, etc....

Care Coordinator - RN - Post Acute Care - $2,500 Sign On Bon...

eviCore healthcare - 125 reviews - Franklin, TN
The Care Coordinator will conduct clinical review to determine medical necessity of Post-Acute Care services utilizing appropriate guideline/criteria for...

Care Coordinator

eviCore healthcare - 125 reviews - Franklin, TN
Acts as clinical expertise team in assisting Medical Directors with medical utilization in post-acute care decisions during secondary reviews....

Utilization Review Specialist - PRN

Elements Behavioral Health - 27 reviews - Franklin, TN 37064
Minimum of one (1) year utilization review work experience. The Utilization Review (UR) Specialist provides expertise of payor behavior and clinical guidelines....

Case Coordinator

Cigna - 2,128 reviews - Nashville, TN
Responsible for the effective and sufficient support of all Utilization Management activities to include prospective/pre-certification review of inpatient and...
Program Specialist, REMS
Reviews EMR for verification of appropriate therapy. Collaborates with REMS manufacturer representative for new program requirements or data review....
Registered Nurse (Utilization Management)
Veterans Affairs, Veterans Health Administration - 2,669 reviews - Nashville, TN
$47,123 - $92,054 a year
The UMN uses the Interqual review criteria, utilization management processes and principles, clinical documentation requirements, current standards of care, and...

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