Utilization Review Nurse - Impactful Care Coordination

American Health Partners

American Health Plans, a division of American Health Partners Inc., seeks a Utilization Review Nurse to assess medical necessity and quality of care for plan members through pre-service, concurrent, and retrospective reviews. You will support the Clinical Services Department and Medical Director, ensuring compliance with medical and regulatory guidelines, while collaborating with providers and accrediting bodies. #J-18808-Ljbffr American Health Partners

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Utilization Review Nurse - Impactful Care Coordination in Franklin, TN vacancy

Utilization Review Nurse - Remote
...Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage... ...Employee Referral Bonus Program JOB SUMMARY: The Utilization Review Nurse is to assess the medical necessity and quality...
Suggested
Full time
Temporary work
Local area
Remote work
American Health Partners
Franklin, TN
18 hours ago
Utilization Review Nurse: Care Optimization & Compliance
...Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc., seeks a Utilization Review Nurse. You will assess the medical necessity and quality of care, conduct UM reviews, and collaborate with the Clinical Services Department to ensure compliant...
Suggested
Remote work
American Health Communities
Franklin, TN
3 days ago
Utilization Review Nurse: Care Quality Advocate
...division of American Health Partners Inc., is seeking an experienced Utilization Review Nurse to support the Clinical Services Department in Franklin, Tennessee. You will assess medical necessity, quality of care, and appropriate level of care for plan members, using...
Suggested
American Health Partners
Franklin, TN
2 days ago
Clinical Nurse Coordinator
...the latest technology enabling nurses to work more efficiently. Are you... ...about delivering patient-centered care? Submit your application for Clinical Nurse Coordinator position and spend more time at... ...and colleagues have a positive impact on patients, communities and healthcare...
Suggested
Hourly pay
Full time
Temporary work
Part time
Flexible hours
Shift work
TriStar Southern Hills Medical Center
Franklin, TN
1 day ago
Emergency Room RN — High-Impact Patient Care
TriStar Centennial Medical Center in Franklin, TN seeks a Registered Nurse to coordinate and deliver high quality, patient-centered care in collaboration with the care team, using established nursing models. The RN will assess pain, perform procedures, document care, respond...
Suggested
TriStar Centennial Medical Center
Franklin, TN
8 hours ago
Outpatient Oncology RN: Radiotherapy Care & Impact
Tennessee Oncology is seeking a Registered Nurse to join our outpatient Radiation Oncology care team. The RN will provide specialized nursing care during... ...assessments, education, IV port access, lab review, and coordination of care with physicians and staff. Oncology experience...
Tennessee Oncology
Franklin, TN
1 day ago
Remote RN Case Manager - Telephonic Care Coordination
...CorVel Corporation seeks a Telephonic Case Manager to coordinate resources and develop cost-efficient, personalized care plans for ill or injured individuals. This remote role emphasizes clinical assessment and collaboration with physicians to optimize treatment and support...
Remote work
CorVel
Franklin, TN
18 hours ago
LPN/RN Coordinator - Ambulatory Care - Full Time
...RN IVF Coordinator We are actively seeking to fill the role of a compassionate... ...: Physician office nurse duties (clinical, specific and... ...Coordinates patient care with the ART program nurses and... ...For further information, please review the Know Your Rights notice from...
Extra income
Full time
Work at office
Monday to Friday
Weekend work
Prelude Fertility
Franklin, TN
1 day ago
Rehab LPN/LVN — Impactful Care & Growth Path
...Tennessee. You'll play a pivotal role in delivering personalized care and supporting patient rehabilitation goals while enjoying a... ...have an LPN/LVN license and are dedicated to making a positive impact, this could be the perfect opportunity for you. #J-18808-Ljbffr...
Encompass Health Corporation
Franklin, TN
8 hours ago
LTSS Service Coordinator-RN Clinician
...The LTSS Service Coordinator RN Clinician is responsible... ...the member's care plan to meet the... ...you will make an impact: Identifies members... ...and efficient utilization of health benefits... ...member's needs, and reviewing and providing input... ...: MA/MS in Health/Nursing preferred. Travels...
Contract work
Temporary work
Work at office
Local area
1 day per week
Elevance Health
Brentwood, TN
18 hours ago
LTSS Service Coordinator-RN Clinician
...LTSS Service Coordinator RN ClinicianThis position... ...the member's care plan to meet the member... ...you will make an impact:Identifies members... ...and efficient utilization of health benefits... ...member's needs, and reviewing and providing input... ...Experience:MA/MS in Health/Nursing preferred.Travels...
Contract work
Temporary work
Work at office
ANTHEM INSURANCE COMPANIES INC
Brentwood, TN
1 day ago
Clinical Nurse Coordinator
...Ready for a role that supports your unique calling in patient care and fits your life? At TriStar Centennial Medical Center, you... .... Job Summary and Qualifications The Clinical Nurse Coordinator (CNC) ensures and delivers high quality, patient-centered care...
Hourly pay
Temporary work
Flexible hours
Shift work
TriStar Centennial Medical Center
Franklin, TN
1 day ago
Remote RN Case Manager: Rehab & Care Coordination
CorVel is seeking a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. This remote... ...Management department and CorVel. The position requires nursing credentials, 3+ years clinical experience, and...
Remote job
CorVel Brand
Franklin, TN
2 days ago
Remote RN Case Manager: Rehab & Care Coordination
...a remote role in the United States. The candidate will coordinate medical case management, assess progress, and discuss treatment options with physicians to ensure quality care and cost efficiency. Strong nursing background and URAC certification eligibility within 3 years...
Remote job
CorVel
Franklin, TN
8 hours ago
Impactful OR Circulator RN — Lead Perioperative Care
Surgery Partners, Inc. seeks an RN Circulator to provide direct nursing care for surgical patients, coordinating with surgeons and the health care team. The nurse oversees the patient through the perioperative process, monitors equipment, and supports care with precise...
Surgery Partners, Inc
Franklin, TN
2 days ago
Staff Development Coordinator (LPN or RN)
...Description Staff Development Coordinator Full-Time | Franklin,... ...Development Coordinator to join our care team. If you're looking for a... ...-services for all staff. Review and update education... ...assigned by the Director of Nursing and/or the Administrator....
Full time
Work experience placement
Franklin Wellness & Rehabilitation Center
Franklin, TN
18 days ago
Registered Nurse - Medical/Surgery - Night Shift
$1,691 - $1,799 per week
...opportunity to make a positive impact on the lives of patients while... ...: The Med Surg Registered Nurse delivers comprehensive high-quality, patient-centered care in medical-surgical and telemetry... ...discharge planning, coordinating with patients, families, and external...
Temporary work
Shift work
Night shift
Fusion Medical Staffing
Franklin, TN
18 hours ago
Registered Nurse, Hospice Home, Full & Part Time
...Difference. Transform End-of-Life Care. Join our company, where... ...document skilled, hands-on nursing care based on each patient’s... ...and risk identification. Coordinate care across interdisciplinary... ...Aptitudes: ~ Sensitivity to the impact of life and death issues...
Daily paid
Full time
Part time
Internship
Local area
Relocation package
Gentiva
Franklin, TN
3 days ago
RN Hospital - Oncology PRN
...Health as a PRN Registered Nurse!The ideal shift would... ...'s redefining infusion care and creating... ...opportunity to make a meaningful impact in patient-centered... ...comfort, seamless care coordination, and specialized infusion... ...Health Record (EHR) system, review nursing documentation,...
Relief
Flexible hours
Shift work
IVX Health
Franklin, TN
18 hours ago
RN Rehab
...exciting time to be a nurse at HCA Healthcare!... ..., long-term care coverage, moving assistance... ...Practice Act. Utilizes therapeutic... ...Provides care and coordinates participation that... ...size to make a real impact in our industry! Our... ...Acquisition team is reviewing applications for...
Full time
Temporary work
Part time
Relief
Flexible hours
TriStar Skyline Medical Center
Franklin, TN
18 hours ago
RN Hospital - Oncology PRN
...Health as a PRN Registered Nurse! The ideal shift... ...'s redefining infusion care and creating exceptional... ...to make a meaningful impact in patient-centered infusion... ...comfort, seamless care coordination, and specialized... ...Health Record (EHR) system, review nursing documentation,...
Relief
Flexible hours
Shift work
IVX Health
Franklin, TN
3 days ago
Hospital Care Registered Nurse (RN) - Surgery
...your unique calling in patient care and fits your life? At... ...grow, and make a meaningful impact every day. Our Step Down Unit... ...team that truly works together. Nurses on this unit gain experience... ...Progressive Care Registered Nurse coordinates and delivers high quality,...
Temporary work
Flexible hours
Shift work
TriStar Centennial Medical Center
Franklin, TN
3 days ago
RN- Health Care (Full-Time
...opportunity to make a real impact with your work? With over 2,000sites of care and serving over 31.2... ...every year, nurses at TriStar Skyline Medical... ...TheIntermediate CareNurse coordinates and delivers high quality... ...Talent Acquisition team is reviewing applications for our...
Full time
Temporary work
Part time
Flexible hours
Shift work
HCA Mission Hospital - Memorial Campus
Franklin, TN
2 days ago
Registered Nurse
...Registered Nurse Career Opportunity Will accept Graduate Nurse applicants... ...' recoveries. Picture the impact of providing individualized, compassionate care that guides patients along their... ...with various departments to ensure coordinated care and provide direct patient...
Full time
Part time
Flexible hours
Encompass Health Rehabilitation Hospital of Franklin
Franklin, TN
4 days ago
Hospice Registered Nurse
...Difference. Transform End-of-Life Care. Join our company, where... ...document skilled, hands-on nursing care based on each patient’s... ...and risk identification. Coordinate care across interdisciplinary... ...: ~ Sensitivity to the impact of life and death issues faced...
Daily paid
Full time
Part time
Internship
Local area
Relocation package
Gentiva Hospice
Franklin, TN
3 days ago
Graduate RN NICU
...employer of Registered Nurses, we’re honored by... ..., high-quality care for which they can... ...provide and coordinate patient care, educate... ...the opportunity to utilize nursing process for... ...size to make a real impact in our industry!... ...Acquisition team is reviewing applications for...
Temporary work
Flexible hours
TriStar Centennial Medical Center
Franklin, TN
18 hours ago
HHH - Registered Nurse (UEX)
...The Baylor Registered Nurse - Home Health Full Time is responsible... ...documenting skilled nursing care in accordance with the developed... ...and satisfaction Directly impact the lives of patients in your... ...functioning level for each client. Coordinate the continuum of hands on...
Full time
Local area
Flexible hours
Aveanna Healthcare LLC
Franklin, TN
4 days ago
Mobile LVN/LPN-Per Diem In-Home Services
...Title & Location Mobile Nurse (LPN/LVN) – Per Diem,... ...entirely on clinical care. Position Details... ...with IQVIA’s clinical coordination team to execute and submit... ...and will be subject to a review of driving record prior... ...to innovation and impact. No matter your role, everyone...
Hourly pay
Daily paid
Full time
Part time
Local area
Immediate start
Worldwide
Flexible hours
IQVIA
Franklin, TN
3 days ago
Full-time RN / LPN Home Health Care
...Position: Licensed Practical Nurse- Maristone of Franklin... ...providing compassionate, high-quality care that enriches the lives of our... ...with facility policies. Coordinate with doctors, CNAs, and other... ...where you can make a meaningful impact ~ Comprehensive health, dental...
Full time
Part time
Work experience placement
Day shift
Triple Crown Senior Living
Franklin, TN
18 hours ago
Clinical Nurse Coordinator
As a Clinical Nurse Coordinator, your voice to influence patient care is valued and empowered at every turn -whether through open, collaborative relationships... ...apply for our Clinical Nurse Coordinator opening. We review all applications. Qualified candidates will be...
Hourly pay
Full time
Temporary work
Flexible hours
Shift work
TriStar Southern Hills Medical Center
Franklin, TN
2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Utilization Review Nurse - Impactful Care Coordination. Be the first to apply!