- Molina Healthcare (Houston, TX)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
- Molina Healthcare (Houston, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... more
- Elevance Health (Houston, TX)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... more
- Apex Health Solutions (Houston, TX)
- …as well as carrying out day today pre-authorization functions. The Utilization Review Nurse will also be responsible for issuing pre-authorization ... more
- Molina Healthcare (Houston, TX)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
- Molina Healthcare (Houston, TX)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
- Houston Methodist (Houston, TX)
- …to department specifications. + Manages utilization management (UM) programs including Medical Claims Review , Precertification and Reconsiderations and ... more
- Houston Methodist (Houston, TX)
- …implements an organized record keeping system for essential/critical documents (ie potential claims , claims , reports and patient/ medical staff matters) that ... more
- GE Vernova (Houston, TX)
- …Presents all financial data in a transparent way, attends project and management review to present cost status + Provides change order calculations to ensure ... more
- GE Vernova (Houston, TX)
- …the test reports as soon as they are finished to the team for review . It's also a responsibility of the Commissioning Specialist to provide feedback about the ... more