- CVS Health (Austin, TX)
- …position are Monday-Friday 9a-6p in time zone of residence. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes ... Qualifications + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...(twice per month) Preferred Qualifications + Prior Authorization or Utilization Management experience + Managed care experience… more
- CVS Health (Austin, TX)
- …Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring precertification. The majority of the time is ... spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed. Required Qualifications + Must have… more
- CVS Health (Austin, TX)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- Humana (Austin, TX)
- …clinical levers, discharge planning, etc.) + Implement, manage, and support contractual Utilization Management & other clinical operations **Use your skills to ... + Five (5) plus years of experience in clinical areas such as: Utilization /Case Management , Claims Resolution, Contract/Market Management , and/or Healthcare… more