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849 Jobs in Nashville, TN

  • Utilization Review Nurse BH WFH

    HCA Healthcare - Nashville, Tennessee
    ... to join our Utilization Review team which is part of the nation's leading provider of healthcare services, HCA Healthcare. Benefits HCA Healthcare offers a total rewards package that ...
  • Utilization Management Review Nurse - RN/SNF required

    Humana - Nashville, Tennessee
    ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse ... the appropriate courses of action. The Utilization Management Registered Nurse 2 uses clinical ...
  • Senior Economist

    Humana - Nashville, Tennessee
    ... ** Experience with Pharmacy Benefit Manager, Pharmacy, or Healthcare data, in particular drug utilization ... company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for ...
  • Utilization Review RN

    Ascension Health - Nashville, Tennessee
    ... , case management, discharge planning and utilization review. Review admissions and service ... with healthcare team members. May prepare statistical analysis and utilization review reports as ...
  • Manager Simulation and Technology

    HCA Healthcare - Nashville, Tennessee
    ... , including position control, scheduling excellence, productivity management, and premium pay utilization ... you as a Manager Simulation and Technology? At Work from Home, you come first. HCA Healthcare has ...
  • Cigna Medicare Population Health Nurse Case Manager

    The Cigna Group - Nashville, Tennessee
    ... clinical assessments, health education, and utilization management to customers, as needed ... Position Summary: Plans, implements, and evaluates appropriate health care services to ...
  • Chief Medical Officer

    HCA Healthcare - Nashville, Tennessee
    ... ** Executives thrive with us! HCA Healthcare is one of the nation’s leading providers of healthcare services ... management, appropriate documents standards, utilization and quality issues, and quality improvement ...
  • Director Clinical Pharmacy and Specialty Operation

    HCA Healthcare - Nashville, Tennessee
    ... utilization, clinical education and staff development, operational optimization of drug products, management ... Operation? At HealthTrust, you come first. HCA Healthcare has committed up to $300 million in programs to ...
  • Medical Director- South Central

    Humana - Nashville, Tennessee
    ... medical interpretation and determinations whether services provided by other healthcare professionals are ... in teams focusing on quality management, utilization management, case management, discharge planning ...
  • Medical Director - Southeast Region

    Humana - Nashville, Tennessee
    ... , other healthcare providers, clinical group practice management. Utilization management experience ... medical interpretation and determinations whether services provided by other healthcare professionals are ...
  • Manager Clinical Pharmacy

    HCA Healthcare - Nashville, Tennessee
    ... Description Introduction Managers thrive with us! HCA Healthcare is one of the nation’s leading providers of healthcare services, comprising of over 180 hospitals and about 2 ...
  • Manager Case Management

    HCA Healthcare - Nashville, Tennessee
    ... HCA Healthcare which is part of the nation's leading provider of healthcare services, HCA Healthcare ... Management Services. Responsible for partnering with developers, technicians, analysts, and business process ...
  • Senior Intake Coordinator

    Highmark Health - Nashville, Tennessee
    ... captures all inbound phone inquires for utilization management review from providers and pharmacies. The ... Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc ...
  • Manager Labor Performance Improvement

    HCA Healthcare - Nashville, Tennessee
    ... improved operations (such as sitter utilization, use of various pay codes, overtime management, etc.) in ... you as a(an) Manager Labor Performance Improvement? At HCA Healthcare, you come first. HCA Healthcare ...
  • Payment Program Specialist

    HCA Healthcare - Nashville, Tennessee
    ... Diploma or GED required Bachelors degree in Finance, Business Management, Healthcare Administration ... HealthTrust Supply Chain today and find out what it truly means to be a part of the HCA Healthcare team ...
  • Medical Director - Florida

    Humana - Nashville, Tennessee
    ... insurance, other healthcare providers, clinical group practice management. Utilization management ... interpretation and determinations whether services provided by other healthcare professionals are in agreement ...
  • Administration Director of Surgical Services

    HCA Healthcare - Nashville, Tennessee
    ... ** Executives thrive with us! HCA Healthcare is one of the nation’s leading providers of healthcare services ... Surgical Services. Unlock your leadership potential with HCA Healthcare. We are an equal ...
  • Product Analyst II

    HCA Healthcare - Nashville, Tennessee
    ... Utilization Review teams in HCA Healthcare facilities. Understands change management processes and can ... Healthcare which is part of the nation's leading provider of healthcare services, HCA Healthcare ...
  • Associate Manager Contracts

    HCA Healthcare - Nashville, Tennessee
    ... you as an Associate Manager Contracts? At HealthTrust, you come first. HCA Healthcare has committed up ... coverage that covers many common services at no cost or for a low copay. Plans include prescription drug ...
  • Case Management RN

    HCA Healthcare - Nashville, Tennessee
    ... resource utilization · Provides case management services for both inpatient and observation patients ... Skyline Medical Center which is a part of the nation’s leading provider of healthcare services, HCA ...
  • Strategy Advancement Advisor

    Humana - Nashville, Tennessee
    ... Utilization Management operating model. The Advisor must exercise independent judgment and decision-making on ... Clinical - Utilization Management (UM) domain** Serve as the primary point of contact (POC) to discuss ...
  • Patient Assessment and Navigation Professional- Remote

    CenterWell - Nashville, Tennessee
    ... education opportunities to drive maximum utilization of available resources, and directing patients on the ... . Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and ...
  • Senior Pharmacy Benefit Accounts Manager

    HCA Healthcare - Nashville, Tennessee
    ... first. HCA Healthcare has committed up to $300 million in programs to support our incredible team ... programs include: Comprehensive medical coverage that covers many common services at no cost or ...
  • C&S Plan Associate Medical Director - Tennessee

    UnitedHealth Group - Nashville, Tennessee
    ... Associate Medical Director’s primary responsibilities are monitoring utilization management, appeals and ... health plan utilization management and appeals and grievance processes – The Associate Medical Director ...
  • Medical Director - Mid West Region

    Humana - Nashville, Tennessee
    ... determinations whether services provided by other healthcare professionals are concordant with national ... , with prior experience participating in teams focusing on quality management, utilization management ...
  • Director Regulatory and Accreditation

    HCA Healthcare - Nashville, Tennessee
    ... focused topics within HCA Healthcare hospitals/ASCs including credentialing, utilization management, peer ... Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our ...
  • Behavioral Health Medical Director

    CVS Health - Nashville, Tennessee
    ... utilization management, quality management, network management and clinical coverage and policies ... . Coordinates with the MCOs' care management staff and providers on medical services not included in the aligned ...
  • Medication Compliance Manager

    HCA Healthcare - Nashville, Tennessee
    ... you as a(an) Medication Compliance Manager? At HCA Healthcare, you come first. HCA Healthcare has ... years. Benefits HCA Healthcare, offers a total rewards package that supports the ...
  • FinOps Cost Opt Practitioner

    HCA Healthcare - Nashville, Tennessee
    ... HCA Healthcare today and find out what it truly means to be a part of the HCA Healthcare team. Benefits HCA Healthcare, offers a total rewards package that supports the health, life, career and ...
  • Manager Meditech Consulting Service

    HCA Healthcare - Nashville, Tennessee
    ... optimization. Management of resource utilization and project assignments, prioritization of task and ... HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like ...
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