HCA, Hospital Corporation of America Division Director of Denials and Centralized Utilization Review in Brentwood, Tennessee

TriStar Health

 

TriStar Health is the region’s largest, most comprehensive healthcare provider with hospitals located in Middle Tennessee and Bowling Green, Kentucky. The healthcare network of choice for thousands of people in the region, TriStar offers the convenience, comfort and individualized care you deserve from your healthcare provider.

Every year, we serve more than 75,000 patients in our 13 hospitals and more than 360,000 patients in our emergency rooms (ERs) throughout Middle Tennessee and Southern Kentucky. With so many locations, you are never far away from a quality hospital or ER.

At each of our locations, you can expect an outstanding selection of doctors, a dedicated team of healthcare professionals and advanced technologies used in everything from joint replacement surgery to cancer treatment.

 

Our Mission

"Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high-quality, cost-effective healthcare in the communities we serve."

HCA's TriStar Divisionis seeking aDirector of Denials and Centralized Utilization Review.

Job Summary

Provide leadership in developing and executing strategic initiatives related to denial management and centralized utilization review. Responsibilities include but are not limited to; root cause analysis and resolution for new denials, developing and executing strategic initiatives for centralized utilization review, including the development of standard processes and policies, and assurance the initiatives meet company and regulatory requirements.

Education

  • College Graduate preferred.

  • Graduate from a accredited school of nursing, social work, occupational therapy, physical therapy, or speech therapy preferred.

Experience

  • 1-3 years of experience in Denial/Appeal or Utilization Review management is required.

  • Strong knowledge of utilization review, interqual application and/or medical necessity, DRG and CPT coding.

Apply Online Today to join this great TriStar Division Team!

Title: Division Director of Denials and Centralized Utilization Review

Location: Tennessee-Brentwood-Nashville FSC

Requisition ID: 08452-60466