- Fresenius Medical Center (Nashville, TN)
- …accounting department. + Acts as the Facility Manager in the absence of the manager or at the direction of management . + Ensure nurses' progress notes are ... **PURPOSE AND SCOPE:** Works with the Facility Manager , facility staff and physician to coordinate the...basis in accordance with policies, procedures and training. Provides nursing support to patients and staff. Assists with staffing,… more
- The Cigna Group (Nashville, TN)
- …regulations and MSSP regulations + HIPAA regulations + Knowledge of care management - utilization management , discharge planning, population health + ... regulations and MSSP regulations + HIPAA regulations + Knowledge of care management - utilization management , discharge planning, population health +… more
- Fresenius Medical Center (Antioch, TN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
- The Cigna Group (Nashville, TN)
- … + Three to Five (3-5) years recent experience in an acute-care environment, case- management or utilization management position (experience can be a ... provider practices + Identifies high-risk/high-cost patients for possible case management intervention. + Interfaces with providers of medical services and… more
- Somatus (Nashville, TN)
- …Practitioner will ensure the delivery of high-quality patient care, efficient medical management , and effective utilization of healthcare resources, delivered by ... providing clinical support and guidance to our Registered Nurse Care Manager and Population Health Field...direction to enable success improving the health engagement and management of a population. The position will work in… more
- Humana (Nashville, TN)
- …II Care Management . Coordinate cases with and refer to tier III Care Manager and Disease Management Programs as appropriate. **Use your skills to make an ... Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review/Quality Management experience + BA/BSN degree + TRICARE… more
- Nashville Center for Rehabilitation and Healing (Nashville, TN)
- …and state regulations and company policy and procedures.Acts as in-house case manager by considering all aspects of the residents care and coordinating services ... and guidelines that govern the process + Acts as an in-house Case Manager demonstrating detailed knowledge of residents health status, critical thinking skills to… more
- HCA Healthcare (Nashville, TN)
- …a work environment where diversity and inclusion thrive? Submit your application for our Manager Case Management opening with HCA Healthcare today and find out ... benefits may vary by location._** We are seeking a Manager Case Management for our team to...facilitate process standardization to promote improved outcomes, maximize resource utilization , and achieve organizational goals. The Manager … more
- Vanderbilt University Medical Center (Nashville, TN)
- …and maintains standards of practice in accordance with evolving practice of case management , social work, and utilization management . Trends and reports ... preeminent programs in patient care, education, and research. **Organization:** Transition Management **Job Summary:** JOB SUMMARY Manages front line staff members… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- …multiple levels of risk\. **Job Description:** **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases ... mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits + Performing the essential activities of case … more
- HCA Healthcare (Nashville, TN)
- …colleagues in their positions. Join our Team as a(an) Home Health RN Clinical Manager and access programs to assist with every stage of your career. **Benefits** ... excellence! As a majority owner of Galen College of Nursing , which joins Research College of Nursing ...skills. Apply today for our Home Health RN Clinical Manager opening and continue to learn! **Job Summary and… more
- Sedgwick (Nashville, TN)
- …PURPOSE** : To ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients by managing and training ... to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Clinical Manager **This manager will have to be...client locations; to provide expertise in client specific case management and utilization review requirements; and to… more
- CenterWell (Nashville, TN)
- …Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as ... management and care coordination. * Experience with case management , social work, skilled nursing facilities, rehab...readmissions, total cost of care, and reducing acute care utilization ). * Familiarity in integrated care management … more
- Wolters Kluwer (Nashville, TN)
- The **Customer Success Manager , Lippincott Solutions** is responsible for driving the implementation of all Nursing Solutions products into existing and new ... with training and rollout, working with reps to drive utilization and customer satisfaction and ensure maximum renewal and...analysis, and creating and presenting a monthly report to management on key metrics. * Support sales growth from… more
- The Cigna Group (Nashville, TN)
- …regarding Medicare appeals and related issues, implications and decisions. The Case Management Analyst reports to the Supervisor/ Manager of Appeals and will ... limited to:** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare...Additional duties as assigned. **Qualifications** + Education: Licensed Practical Nurse (LPN) or Registered Nurse (RN) +… more
- J&J Family of Companies (Nashville, TN)
- …care. The CAR-T Cell Therapy Experience Lead is a member of this account management team, reporting to the Senior Manager , CAR-T Cell Therapy Experience Lead. ... raising the bar on customer experience in the pharmaceutical industry. Our account management teams support the certified sites who care for cancer patients. We are… more
- CenterWell (Nashville, TN)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... course of action. + Delegation Oversight of Home infusion Nursing Vendors and local providers + Supervise through qualified...criteria for admission to service, case assignments, and case management . + Represent the pharmacy in a professional and… more
- Sharecare, Inc. (Nashville, TN)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...Patient Care Technician (PCT) + Physical Therapy Assistant + Nursing Assistant + Medical Secretary/Clinic Manager +… more
- HCA Healthcare (Nashville, TN)
- …assessments of focused topics within HCA Healthcare hospitals/ASCs including credentialing, utilization management , peer review, medical staff and board bylaws, ... department manager or director experience and success) * Registered nurse , registered pharmacist, a laboratory specialist to include a medical technologist… more
- HCA Healthcare (Nashville, TN)
- …labor management , including position control, scheduling excellence, productivity management , and premium pay utilization ; Maintain staffing to ensure ... of Cardiovascular Services with TriStar Centennial Medical Center, you can be a manager in an organization that is devoted to giving! **Benefits** TriStar Centennial… more