- Humana (Austin, TX)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Humana (Austin, TX)
- …independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review cases using clinical knowledge, ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- Conviva (Austin, TX)
- …+ Prior clinical experience, managed care experience, Home Health, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Ascension Health (Austin, TX)
- … Review RN, you'll provide health care services regarding admissions, case management , discharge planning and utilization review . + Review ... **Details** + **Department:** Utilization Review + **Schedule:** Full-time, 8-hour...coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure… more
- Lincoln Financial Group (Austin, TX)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Centene Corporation (Austin, TX)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- HCA Healthcare (Austin, TX)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for both ... stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in...growth, we encourage you to apply for our Registered Nurse Case Manager opening. We review all… more
- HCA Healthcare (Austin, TX)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for both ... stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in...compelling, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review … more
- HCA Healthcare (Austin, TX)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for both ... stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in...compelling, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review … more
- HCA Healthcare (Round Rock, TX)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for both ... stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in...growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review … more
- HCA Healthcare (Georgetown, TX)
- …+ **Minimum of 5 years of clinical practice, minimum of 3 years in a management role such as Charge Nurse or similar** **Education** + **Associate's degree in ... in the absence of other members of the nursing management /administrative team. + You will direct staff members appropriately...growth, we encourage you to apply for our Registered Nurse House Supervisor PRN opening. We review … more
- Prime Therapeutics (Austin, TX)
- …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Magellan Credentialing ... and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description Summary** Under supervision, is responsible for performing… more
- HCA Healthcare (Austin, TX)
- …find this opportunity compelling, we encourage you to apply for our Registered Nurse House Supervisor opening. We promptly review all applications. Highly ... where diversity and inclusion thrive? Submit your application for our Registered Nurse House Supervisor opening with St. David's North Austin Medical Center today… more
- HCA Healthcare (Round Rock, TX)
- …satisfaction and personal growth, we encourage you to apply for our Registered Nurse Supervisor House PRN opening. We review all applications. Qualified ... you have the PRN career opportunities as a(an) Registered Nurse Supervisor House PRN you want with your current...in the absence of other members of the nursing management /administrative team. + You will direct staff members appropriately… more
- Elevance Health (Austin, TX)
- …**Minimum requirements:** + Requires minimum of 3 years acute care clinical experience, utilization management or managed care experience; or any combination of ... ** Nurse Medical Management Sr.** **Location:** **multiple...May also manage appeals for services denied. + Stay review , care coordination, and discharge planning for appropriateness of… more
- HCA Healthcare (Austin, TX)
- …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse position and spend more time at the bedside with the patient. ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at North...Summary and Qualifications** We are seeking an Operating Room Nurse for our ambulatory surgery center who demonstrates the… more
- Fresenius Medical Center (Austin, TX)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Home Care Providers of Texas (Austin, TX)
- …to meet the needs of each individual patient. + Responsible for evaluating utilization of patient services and patient progress. Review evaluation with the ... Health (Geriatrics) experience + Texas Nursing License + Strong organizational and self- management skills + Strong and compassionate customer service skills + Valid… more
- Sedgwick (Austin, TX)
- …and consult review ; and two (2) years of experience in daily application of nurse auditing, utilization review and bill review . **Skills & ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Bill Review **PRIMARY PURPOSE** **:** To review hospital and professional medical… more
- Centene Corporation (Austin, TX)
- …Knowledge of NCQA, Medicare and Medicaid regulations is preferred. Knowledge of utilization management processes is preferred. **License/Certification:** + LPN - ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more