199 utilization jobs at 102 companies in Columbia, TN
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Utilization Specialist
Burns, Tennessee, United States
OnsiteFull Time
Acadia HealthcareNasdaq: ACHC: Provider of inpatient and outpatient behavioral health services.
2+ YOEClinical experience or 2+ years working with the facility population; high school diploma; preferred health/social work degrees; preferred clinical licensure; CPR and de-escalation/restraint training; ability to conduct utilization reviews and appeals.
Acadia HealthcareNASDAQ: ACHC: Provides inpatient and outpatient behavioral healthcare and addiction treatment.
2+ YOEHigh school diploma required. Clinical experience required or 2+ years working with the facility population. Preferred healthcare degree and clinical licensure. CPR and de-escalation/restraint training required.
Boston or Chicago or New York City or Washington or Nashville
$85-$95/hrRemoteContract, Temporary
Chartis: Strategic consulting and data analytics for the healthcare sector.
Design, configure, implement, and support Epic Tapestry Utilization Management workflows; ensure regulatory compliance; perform testing and documentation; partner with clinical and operational teams.
Epic, Epic Tapestry, Tapestry Care Link, SmartTools, SmartText
Odyssey Behavioral Healthcare: Operates specialized residential and outpatient behavioral health treatment facilities.
3+ YOEManage daily utilization review operations, lead and coach coordinators, perform medical record reviews, audit quality, support denial prevention and regulatory compliance.
Odyssey Behavioral Healthcare: Operates residential and outpatient mental health and addiction centers.
7+ YOEBachelor's degree required; master's preferred in nursing, Healthcare Administration, or Business Administration; clinical licensure preferred; 7+ years UR leadership experience in behavioral health; KPI/reporting experience required.
American Health Partners: Provides specialized healthcare services and Medicare Advantage plans for seniors.
1+ YOEAssess medical necessity and quality of care for members; perform pre-service, concurrent, and retrospective reviews; apply clinical criteria and consult physicians; RN license required.
Navitus Health Solutions: Transparent pharmacy benefit management and specialty pharmacy provider.
3+ YOEPharmD, active state pharmacist license, 3 years clinical or managed care experience preferred, strong communication, Excel/Office proficiency, remote/hybrid options.
Microsoft Excel, Microsoft PowerPoint, Microsoft Word
AccentureNYSE: ACN: Global provider of management consulting and technology services.
5+ YOE5+ years in Healthcare IT in an Epic non-clinical leader role, Epic Tapestry certification and certification in an Epic non-clinical app, bachelor's degree or equivalent, project planning, stakeholder communication, and system configuration/testing experience.
Nashville Electric Service: Provides electricity distribution services to Nashville and Middle Tennessee.
6+ YOEHigh school diploma, six years utility experience including four years as journeyman/cable splicer and completion of apprenticeship; drug/alcohol clean 12 months, no recent suspensions, passing safety test, able to attain CDL and distinguish colors.
Clinical Program Manager, Utilization Management - Remote
Houston or Atlanta or Nashville or New Orleans or Charlotte or Tampa
$92k-$164k/yrRemoteFull Time
UnitedHealth GroupNYSE: UNH: Provides health insurance and technology-enabled health care services.
5+ YOE4+ MgmtMaster's/doctoral in behavioral health, current unrestricted independent clinical license, 5+ years post-licensure clinical experience, 4+ years people management, utilization management knowledge.
Brentwood: Provides public safety and municipal services to Brentwood citizens.
3+ YOEHigh school diploma/GED, 3–5 years of water and wastewater experience, Tennessee Class II water distribution or sewer collections license, cross-connections certification, driver's license, and CDL within one year.
SCADA, electronic monitoring and documentation systems
Samaritan Recovery Community: Provides comprehensive addiction treatment and recovery support services.
2+ YOE2 years college/associate or LADAC eligible; 2+ years experience in substance abuse treatment admissions/medical records; experience with insurance precertification, continued stay reviews, client assessments, billing, and TNWITS.
Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)
Nashville or Charleston or Beaufort or Columbia or Sumter
HybridFull Time
BlueCross BlueShield of South Carolina: Provides health insurance and healthcare administrative services.
5+ YOE2+ MgmtBachelor's degree, 5 years clinical and utilization review experience with 2 years supervisory; active RN licensure (state or NLC), Microsoft Office proficiency, strong communication and analytical skills.
Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)
Nashville, Tennessee, United States
HybridFull Time
CGS Administrators: Provides administrative services and claims processing for Medicare programs.
5+ YOE2+ MgmtBachelor's degree required; 5 years clinical and utilization review experience including 2 years supervisory experience; active RN licensure (state or NLC); strong communication, analytical, and regulatory knowledge; Microsoft Office proficiency.
JacobsNYSE: J: Global provider of professional engineering and technical services.
8+ YOE8+ years utility coordination experience with TDOT or state DOT standards; knowledge of electric, gas, water, sewer, stormwater, telecom, and fiber utilities; experience identifying utility conflicts and coordinating relocations.
City of Franklin: Provides municipal services and governance to the local community.
4+ YOEAssociate's degree or equivalent and 4+ years utility-related experience; valid driver\u0019s license; knowledge of water/wastewater practices, CAD, SCADA, and utility regulations.
AutoCAD, MicroStation, Microsoft Word, Microsoft Excel, Microsoft Outlook, Adobe, Bluebeam, SCADA
RAWSO: Heavy civil construction and excavation services in Middle Tennessee.
Experience operating hydraulic excavators for underground utility construction, knowledge of excavation and trenching safety, ability to read utility markings and construction plans, strong communication with crews, dependable attendance.