- Baylor Scott & White Health (Austin, TX)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Molina Healthcare (Austin, TX)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… 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
- HCA Healthcare (Georgetown, TX)
- …Science in Nursing (BSN) - preferred** **Licenses and Certifications** + **Current State of Texas Registered Nurse ( RN ) license or Compact Registered ** + ... of clinical practice, minimum of 3 years in a management role such as Charge Nurse or...encourage you to apply for our Registered Nurse House Supervisor PRN opening. We review … more
- HCA Healthcare (Austin, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We review all applications. Qualified candidates will ... Do you have the PRN career opportunities as a Registered Nurse Case Manager PRN you want...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- HCA Healthcare (Austin, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... Do you have the PRN career opportunities as a Registered Nurse Case Manager you want with...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- HCA Healthcare (Austin, TX)
- …Center we support our colleagues in their positions. Join our Team as a NICU Registered Nurse Case Manager and access programs to assist with every stage of ... gain certifications and job skills. Apply today for our Registered Nurse Case Manager opening and continue...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- HCA Healthcare (Austin, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... We care like family! Jump-start your career as an Registered Nurse Case Manager today with St....supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- HCA Healthcare (Round Rock, TX)
- …Medical Center we support our colleagues in their positions. Join our Team as a Registered Nurse Case Manager and access programs to assist with every stage of ... gain certifications and job skills. Apply today for our Registered Nurse Case Manager opening and continue...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- HCA Healthcare (Round Rock, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... Do you have the PRN career opportunities as a Registered Nurse Case Manager you want with...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- HCA Healthcare (Austin, TX)
- …Science in Nursing (BSN) - preferred** **Licenses and Certifications** + **Current State of Texas Registered Nurse ( RN ) license or Compact Registered ** + ... Do you have the PRN career opportunities as a(an) Registered Nurse House Supervisor PRN you want...in the absence of other members of the nursing management /administrative team. + You will direct staff members appropriately… more
- Highmark Health (Austin, TX)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… 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 ... looking for talent and will consider all who respond. Seeking Full-Time Home Health Registered Nurses in the North and South Austin, TX and surrounding areas! Now… more
- Centene Corporation (Austin, TX)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- CVS Health (Austin, TX)
- …may include weekends and holidays and evening rotations._ This is a full-time remote Utilization Management Nurse Consultant opportunity. As a Utilization ... of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical...residence with 6 weekends per year with rotating Holidays. Utilization management is a 24/7 operation. Work… more
- Molina Healthcare (Austin, TX)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
- CVS Health (Austin, TX)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
- Molina Healthcare (Austin, TX)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... and results across Molina Health Plans & Segments. **KNOWLEDGE/SKILLS/ABILITIES** + Review existing case management standards and processes and establishes… more
- Guardian Life (Austin, TX)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… 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 ... consider all who respond. Seeking a Weekend Home Health Registered Nurses in the North and South Austin, TX...experience + Texas Nursing License + Strong organizational and self- management skills + Strong and compassionate customer service skills… more