- CVS Health (Austin, TX)
- …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... Clinical Social Worker (LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100%… more
- CVS Health (Austin, TX)
- …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can… more
- CVS Health (Austin, TX)
- …applications (Outlook, Teams, Excel) **Preferred Qualifications** + Prior Authorization or Utilization Management experience in Medicare lines of business + ... Mon-Fri 8-5 PM in your time zone and is for a** **Medicare Precertification Nurse .** _Utilization Management is a 24/7 operation and work schedules will include… more
- CVS Health (Austin, TX)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Central time zones… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Molina Healthcare (Austin, TX)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes...be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and… more
- Centene Corporation (Austin, TX)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… 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 ... opportunity to make a real impact. As a(an) Registered Nurse Case Manager NICU PRN you can be a...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Austin, TX)
- …Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse Case Manager you can be a part of change. **Benefits** St. David's Medical ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… 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 ... opportunity to make a real impact. As a(an) Registered Nurse Case Manager PRN you can be a part...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Round Rock, TX)
- …us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** St. David's Round Rock ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- Centene Corporation (Austin, TX)
- …preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes 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
- 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 ... in their positions. Join our Team as a(an) Registered Nurse Case Manager and access programs to assist with...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… 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 ... in their positions. Join our Team as a(an) Registered Nurse Case Manager and access programs to assist with...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… 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 ... Do you have the career opportunities as a Registered Nurse Case Manager PRN you want in your current...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Austin, TX)
- …passionate about delivering patient-centered care?** Submit your application for Seasonal Registered Nurse Case Manager position and spend more time at the bedside ... work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at St. David's Medical Center!… more
- Evolent (Austin, TX)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Evolent (Austin, TX)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
- HCA Healthcare (Round Rock, 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. ... work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Columbia Oakwood Surgery Center!… more
- CVS Health (Austin, TX)
- …candidates in compact RN states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for ... - 5 years clinical practice experience as an RN - 6+ months Case Management or Utilization Management experience - Must be able to work Monday through Friday… more