- Molina Healthcare (Houston, TX)
- …knowledge on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or Bachelor's ... settings. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) or State Clinical Social Worker/Counseling… more
- Molina Healthcare (Houston, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Molina Healthcare (Houston, TX)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- UTMB Health (Friendswood, TX)
- …from an accredited school of Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum of five (5) years full-time wage ... quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical...earning experience as a professional nurse in a healthcare setting with at least two… more
- Apex Health Solutions (Houston, TX)
- …Certification requirements, as well as carrying out day today pre-authorization functions. The Utilization Review Nurse will also be responsible for issuing ... to practice as a Registered Nurse or Licensed Vocational Nurse required and current unrestricted Certification in Utilization Review / Utilization… more
- HCA Healthcare (Houston, TX)
- …growth, we encourage you to apply for our Registered Nurse RN PACU PRN opening. We review all applications. Qualified candidates will be contacted ... Do you have the PRN career opportunities as a(an) Registered Nurse RN PACU PRN...all practices in the PACU. + Proficient in the utilization of specialized skills to provide care to patients… more
- HCA Healthcare (Webster, TX)
- …personal growth, we encourage you to apply for our Registered Nurse RN Case Manager PRN opening. We review all applications. Qualified candidates will be ... Do you have the PRN career opportunities as a(an) Registered Nurse RN Case Manager...utilization **What qualifications you will need:** + Current Registered Nurse License in the State of… more
- HCA Healthcare (Pasadena, TX)
- …career path, we encourage you to apply for our Registered Nurse RN PACU PRN opening. We review all applications. Qualified candidates will be contacted ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN PACU PRN...all practices in the PACU. + Proficient in the utilization of specialized skills to provide care to patients… more
- Houston Methodist (Houston, TX)
- …HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of...Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… 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, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
- ChenMed (Houston, TX)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... great people to join our team. The Acute Care Nurse is responsible for achieving positive patient outcomes, managing...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
- Actalent (Houston, TX)
- …Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to oversee and review both handwritten and computer-generated medical ... reviews. Essential Skills + Active TX RN License + Experience in Utilization Management and Concurrent Review + Strong communication skills + Strong computer… more
- Fresenius Medical Center (Crosby, 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
- Kelsey-Seybold Clinic (Pearland, TX)
- …both delegated commercial and Medicare Benefit products. Manage all aspects of utilization review and claims in accordance with regulatory and accreditation ... 3 - 5 years of project management experience Nursing experience in support of Utilization Review or Claims processing **License(s)** Required: N/A Preferred: TX … more
- HCA Healthcare (Pasadena, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Case Manager you want with...preferred + Current Texas licensure with State Board of Nurse Examiners as an RN + 1+… more
- MD Anderson Cancer Center (Houston, TX)
- …Practice. May be waived for applicants who obtained recognition as an Advanced Practice Registered Nurse from the Texas State Board of Nursing prior to 1/1/2003. ... Written authorization from the Texas Board of Nursing to function as an Advanced Practice Registered Nurse (APRN or ACNP or ACNPC or ACAGNP or AGACNP or ACNPC-AG… more
- Molina Healthcare (Houston, TX)
- …abuse through the identification of aberrant coding and/or billing patterns through utilization review . * Incorporate leadership and communication skills to work ... care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED… more
- Actalent (Houston, TX)
- …Essential Skills + Active TX RN or LVN License + Experience in utilization management and concurrent review + Strong communication skills + Proficiency in ... Job Title: Prior Authorization Nurse (Must be located in Texas) Job Description...Description + We are seeking a dedicated Prior Authorization Nurse to routinely reviews prior authorization requests to determine… more
- MD Anderson Cancer Center (Houston, TX)
- …or treatment team concerning home care, potential problems, emotional concerns or utilization review status. Participates in regularly scheduled team conferences ... operations. Remains abreast of developments in the field of nursing or utilization review by attending seminars and workshops, communicating with peers,… more
- Molina Healthcare (Houston, TX)
- …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity,... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more