utilization review jobs in Nashville, TN

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Preservice Review Nurse - Telecommuting!
UnitedHealth Group 2,186 reviews - Brentwood, TN
Perform utilization review using Milliman (MCG) criteria. Preservice Review Nurse! RN, Registered Nurse, UR, UM, Pre-Authorization, Utilization Review,...
Sponsored by UnitedHealth Group
Preservice Review Nurse RN - Telecommute from Tennessee
UnitedHealth Group 2,186 reviews - Brentwood, TN
Perform prior authorizations, utilization and concurrent reviews using Milliman criteria. Utilization review, utilization management, prior authorization, case...
Sponsored by UnitedHealth Group
Senior Consultant - Healthcare Coding
FTI Consulting, Inc. 37 reviews - Nashville, TN
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 strategies, and support...
Sponsored by FTI Consulting, Inc.

UM Clinical Team Lead - RN (Nashville)

TriWest Healthcare Alliance 98 reviews - Nashville, TN
1 year experience in Utilization management. The VA will then review this paperwork and verify your citizenship....

Utilization Case Manager

Medix 35 reviews - Nashville, TN
As a Utilization Case Manager , you will be responsible for utilization reviews and resource management of acute care patients....

Medical Review Nurse

NCI Information Systems, Inc. 134 reviews - Nashville, TN
2 years of experience with utilization/quality assurance review and ICD-9/10-CM/CPT-4 coding. As the Medical Review Nurse ( Medical Reviewer III ) at AdvanceMed...

Provider Relations Representative

WellCare 130 reviews - Brentwood, TN
Conducts site visits to service providers, resolve issues, educate staff/providers on policies, collect credentialing information, and review HEDIS information....

Claims Representative-Liab

Sedgwick Claims Management Services 255 reviews - Nashville, TN
May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments...

Case Manager

WellCare 130 reviews - Brentwood, TN
Promotes effective utilization and monitors health care resources. Intermediate Ability to create, review and interpret treatment plans Ability to create,...

Preservice Review Nurse RN - Telecommute from Tennessee

UnitedHealth Group 2,186 reviews - Brentwood, TN
Perform prior authorizations, utilization and concurrent reviews using Milliman criteria. Utilization review, utilization management, prior authorization, case...

Advanced Medical Support Assistant (Transplant)

Department of Veterans Affairs 1,099 reviews - Nashville, TN
Coordinates with the patient care team to review the clinic utilization by using various reports. Tour of Duty:....

SW/RN BH Case Manager (UM) - Nashville

Cigna 966 reviews - Nashville, TN
Familiarity in appropriately applying Level of Care Guidelines, including InterQual and ASAM Criteria, for utilization review....

Denials & Appeals Specialist, Nurse

Revenue Cycle Service Center - Franklin, TN
Utilization review and/or case management experience preferred. Review all assigned inpatient denials; Understanding and utilization of medical necessity...
RN Utilization Review
CES, LLC - Nashville, TN
LEAD CLAIMS REVIEW ANALYST*. Previous Medicare Medical Review experience is preferred. At least 5 years utilization/quality assurance review and ICD-9-CM/CPT...
Easily apply
Sponsored by CES, LLC
Case Manager
Select Specialty Hospital - Nashville, TN
This position is responsible for documentation compliance for regulations governing Utilization Review and Discharge Planning....
Easily apply
Sponsored by Select Specialty Hospital

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Company with utilization review jobs
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