Insurance Sales Representative (Remote/Hybrid | Local Territory) The Compass Business GroupInsurance Sales Representative (Remote/Hybrid | Local Territory)Old Hickory, TennesseeRemoteOur mission-driven team thrives on service, integrity, and results empowering you to make a meaningful impact while building a successful career. At Compass Business Group , we help protect families, teams, and small businesses through supplemental insurance solutions.
Healthcare Integration Analyst EvidenceCareHealthcare Integration AnalystNashville, TNRemoteEvidenceCare is a unique clinical decision support system (CDSS) because of its EHR-integrated platform that optimizes clinician workflows to deliver better patient care, reduce hospital costs, and capture more revenue. As a valued partner on the Product and Engineering teams, you will use your technical knowledge and understanding of EvidenceCare's business and clinical objectives to ensure reliable integrations are delivered to our customers.
Employee Experience (EX) Advisor - Healthcare Press Ganey Associates LLCEmployee Experience (EX) Advisor - HealthcareTNRemote$81,000–$115,000 / yearHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. Press Ganey is the leading experience measurement, data analytics, and insights provider for complex industries-a status we earned over decades of deep partnership with clients to help them understand and meet the needs of their key stakeholders.
Remote Triage - RN Elevance HealthRemote Triage - RNNashville, TennesseeRemoteWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
NewRemote Triage - RN Elevance Health IncRemote Triage - RNNashville, TNRemoteWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How you will make an impact: Provides information about the RPM Program to members with chronic conditions and explains the benefit of having chronic conditions managed, assessed and treated.
Government Programs RN Care Manager III Tailored ManagementGovernment Programs RN Care Manager IIINashville, TNRemote$43.18–$46.05 / hourIn this role, the Care Manager will assess, plan, implement, coordinate, monitor, and evaluate care options and services to help members improve health outcomes while navigating illness, injury, and barriers to care. This fully remote role is ideal for a Registered Nurse who has strong clinical judgment, case management experience, and the ability to support members telephonically with compassion, professionalism, and attention to detail.
Regional Director of Quality Quorum Health CorpRegional Director of QualityBrentwood, TNRemoteWorks closely with Clinical and Non-Clinical teams for improvement on key performance indicators, designs processes for new initiatives, services and other targets identified by Roosevelt General Hospital leadership. Key Responsibilities: Facilitates alignment between improvement initiatives and the organizations strategic plan; directs the day to-day execution of the strategies and tactic necessary to successfully improve the outcomes and results of the organization.
Nurse Case Management Senior Analyst MindlanceNurse Case Management Senior AnalystNashville, TNRemoteEstablishes a documented patient centric care management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved. The Care Manager will promote quality cost-effective outcomes managing care needs through the continuum of care utilizing effective verbal and written communication skills and a consumerism approach through education and health advocacy to members serviced.
NewDirector Quality Operations 2800-QHCCS, LLCDirector Quality OperationsBrentwood, TNRemotePart timeWorks closely with Clinical and Non-Clinical teams for improvement on key performance indicators, designs processes for new initiatives, services and other targets identified hospital leadership. Focuses on better healthcare value and quality, including the improvement of clinical outcomes, patient experience, patient safety, costs, revenue, productivity, efficiency, employee and physician satisfaction, and process reliability.
Director Quality Operations Quorum Health CorporateDirector Quality OperationsBrentwood, TennesseeRemoteWorks closely with Clinical and Non-Clinical teams for improvement on key performance indicators, designs processes for new initiatives, services and other targets identified by Roosevelt General Hospital leadership. Focuses on better healthcare value and quality, including the improvement of clinical outcomes, patient experience, patient safety, costs, revenue, productivity, efficiency, employee and physician satisfaction, and process reliability.
Remote Hospice Triage RN PT Weekend Only 7:30a-6p CST IntellaTriage, Inc.Remote Hospice Triage RN PT Weekend Only 7:30a-6p CSTNashville, TNRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT 3:30p-11p + rotating Sat & Sun 9:30a-4p CST IntellaTriage, Inc.Remote Hospice Triage RN PT 3:30p-11p + rotating Sat & Sun 9:30a-4p CSTNashville, TNRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN FT Monday-Friday 6:30a-4p (No Wknds) IntellaTriage, Inc.Remote Hospice Triage RN FT Monday-Friday 6:30a-4p (No Wknds)Nashville, TNRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT 3:30p-11p + rotating Sat & Sun 9:30a-4p CST IntellaTriageRemote Hospice Triage RN PT 3:30p-11p + rotating Sat & Sun 9:30a-4p CSTNashville, TNRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN FT Monday-Friday 6:30a-4p (No Wknds) IntellaTriageRemote Hospice Triage RN FT Monday-Friday 6:30a-4p (No Wknds)Nashville, TNRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
Remote Hospice Triage RN PT Weekend Only 7:30a-6p CST IntellaTriageRemote Hospice Triage RN PT Weekend Only 7:30a-6p CSTNashville, TNRemoteUtilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008.
NewUtilization Management Behavioral Health Professional Humana IncUtilization Management Behavioral Health ProfessionalTNRemote$65,000–$88,600 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Humana Healthy Horizons in Kentucky is looking for a Utilization Management Behavioral Health Professional 2 who uses behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Nashville, TNRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Director, Medical Document Optimization TriWest Healthcare AllianceDirector, Medical Document OptimizationNashville, TNRemoteFull timeLeadership: Ability to set strategic direction and translate organizational goals into operational plans; successfully leads and develops staff across varying styles and levels; provides clear expectations, effective coaching, and timely feedback; leads through a subordinate manager and drives accountability at all levels of the department. Problem Solving / Analysis: Ability to solve complex operational and systems-related problems through systematic analysis of data, workflows, and processes; exercises sound judgment in ambiguous or high-stakes situations; identifies root causes and implements durable solutions with a realistic understanding of organizational constraints.
Clinical Content Specialist - Nursing (Integration Nurse Educator, Central - Traditional Programs) Wolters Kluwer N.V.Clinical Content Specialist - Nursing (Integration Nurse Educator, Central - Traditional Programs)TNRemote$71,300–$124,500 / yearCollaborate with cross-functional teams and external partners to deliver strategic, high-impact faculty engagement, ensuring effective integration of Lippincott and NurseTim products and services into nursing curricula. The Clinical Content Specialist will play a key role in supporting faculty adoption of best practices, integrating our solutions into curricula, and preparing students for licensure and professional practice.
Behavioral Health Clinical Specialist (LPN or RN)- Remote Fast Pace HealthBehavioral Health Clinical Specialist (LPN or RN)- RemoteFranklin, TennesseeRemoteFull timeAs an additional team member of the call center, you will assist the call center specialists with scheduling of intake & follow-up appointments, assisting with online registration and check-in, assisting patients with use of technology to see providers, verifying insurance for eligibility for behavioral health services, input of patient insurance information in the system, creating chart for patient in prescription system, ensuring any intake triage orders are given to patient and scanned in the chart if applicable before the first appointment, and completing outside referrals from our behavioral health providers. He or she will listen to the patients’ requests and take appropriate action to respond, including communicating with providers about patient or medication concerns, communicating with the pharmacy to verify prescriptions or to call in refills, completing prior authorization forms, school medication forms, assisting with patient letters, and provide information to clinics who are referring to behavioral health services.
Clinical Nurse Manager Travel Staffing Ascension Health AllianceClinical Nurse Manager Travel StaffingNashville, TNRemote$107,821–$145,875 / yearOur legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. Education: Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required.
Bilingual Spanish, RN Care Manager Clover Health Investments CorpBilingual Spanish, RN Care ManagerNashville, TNRemote$86,000–$105,000 / yearAdditional Perks: Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities Reimbursement for office setup expenses Monthly cell phone & internet stipend Remote-first culture, enabling collaboration with global teams Paid parental leave for all new parents. The Clover Care Services organization delivers proactive support and care to our members through our clinical Clover Home Care teams, and quality improvement services to our aligned providers through our practice engagement team.
Chief of Staff to the Chief Operating Officer TriWest Healthcare AllianceChief of Staff to the Chief Operating OfficerNashville, TNRemoteFull timeTechnical Skills: Proficient in current trends in health care management with emphasis in customer service, network management, utilization and financial trends; collaboration skills to work with TriWest management team across multiple locations; networking skills with all levels, including subcontractors. • Works on multiple high level projects including logistical coordination, data analysis, contract management and written communications in support of various business initiatives of high visibility, applying project management tools and methodologies and leadership skills to meet or exceed deadlines.
Clinical Reviewer, RN/LPN (Remote - TN) Maximus IncClinical Reviewer, RN/LPN (Remote - TN)Nashville, TNRemoteMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. This position plays a key role in helping eligible children and their families access healthcare coverage, home and community-based services, and other critical supports that enable children to remain safely at home and actively participate in their communities.
Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerNashville, TNRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.