utilization review jobs in Nashville, TN

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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
Continuous Quality Improvement RN
MHM - Nashville, TN
Coordinates/conducts regular review of healthcare practices based on medical record audits. Conducts studies, provide statistical analysis regarding reviewed...
Easily apply
Sponsored by MHM
Senior Consultant - Healthcare Coding
FTI Consulting, Inc. - 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.

Utilization Review Associate / Metro Center / FT Days

Metro Center 2 reviews - Nashville, TN
The Utilization Review Associate analyzes and evaluates concurrent admission information and assigned patient population to support admission and discharge...

Coordinator - Clinical Applications - FT Days

Centennial Medical Center 57 reviews - Nashville, TN
Evidence Based Order set review, approval, and build within the facility. Actively supports and promotes systems standardization, utilization, and best...

Medical Case Manager - Field (WFH)

Berkley Medical Management Solutions - Nashville, TN
Review job analysis with physician. Assess appropriate utilization of medical treatment and services available through contact with physicians and other...

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,...

Medicare Medical Review RN

NCI Information Systems, Inc. 133 reviews - Nashville, TN
At least two (2) years utilization/quality assurance review and ICD-9/10-CM/CPT-4 coding experience. As the Medical Review Nurse ( Medical Reviewer ), you are...

Manager Clinical Affairs

Sarah Cannon Research Institute Clinical Operation... - Nashville, TN
Manage departmental resources to ensure department meets minimum utilization expectations. Manage the performance of direct report personnel, including role...

Director, Medical Necessity Review

Corporate Parallon - Franklin, TN
Develop standards including policies, procedures, and tools that promote operational efficiency around quality medical necessity reviews....

Medical Review Manager

CGS Administrators - Nashville, TN
Five years of clinical and utilization review experience. Oversees the accurate processing of claims that have been deferred for medical necessity review....

Nurse Review Auditor (Franklin, TN)

EnableComp, LLC - Franklin, TN
Utilization Review, Nurse Auditor, EnableComp, Worker's Compensation, Medical Billing, Healthcare Claims Collections....

BPCI RN Case Manager

eviCore healthcare - Franklin, TN
Performs utilization review activities for Post Acute Care requests and contacts providers where additional information is necessary to make a decision....
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....
Easily apply
Sponsored by CES, LLC

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Company with utilization review jobs
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