- Molina Healthcare (Dallas, TX)
- …SKILLS & ABILITIES** : + 2 or more years in case, disease or utilization management; managed care; or medical/behavioral health settings. + One year of ... **PREFERRED EXPERIENCE** : 5 or more years in case, disease or utilization management; managed care; or medical/behavioral health settings. **PREFERRED LICENSE,… more
- Actalent (Dallas, TX)
- …Title: Utilization Management NurseJob Description We are seeking a dedicated Utilization Management Nurse to review handwritten and computer-generated ... documents, ensuring tasks are prioritized effectively. The nurse will be responsible for assessing medical necessity for...Skills + Active TX RN License + Experience in utilization management and concurrent review + Strong… more
- Actalent (Dallas, TX)
- …of concurrent review experience and/or discharge planning + 2 years of utilization review /management experience + 1 year of experience within Case Management ... Job Title: PAC NurseJob Description The PAC Nurse is a telephonic position responsible for recommending...telephonic touch points with each facility point person to review each member within that facility and confirm appropriateness… more
- Molina Healthcare (Dallas, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level… more
- Texas Health Resources (Dallas, TX)
- ** Nurse Manager - GI Lab** _Are you looking for...for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health Dallas ... Friday; Day Shift For more than a half-century, Texas Health Dallas has been at the forefront of ...this purpose. Provide resources and guidance to support the utilization of evidence based practice standards. Identify and utilize… more
- Texas Health Resources (Fort Worth, TX)
- ** Nurse Manager - Telemetry** _Are you looking for...for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health ... Southwest + Core work hours: Monday-Friday 8:00a-5:00p At Texas Health Southwest and Texas Health Clearfork we're one hospital in two locations. We're a 261-bed,… more
- Molina Healthcare (Dallas, 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 cases… more
- HCA Healthcare (Dallas, TX)
- …Center have the opportunity to make a real impact. As an Operating Room Nurse you can be a part of change. **Benefits** Medical City Ambulatory Surgery Center ... offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential… more
- HCA Healthcare (Mckinney, TX)
- …satisfaction and personal growth, we encourage you to apply for our OR Registered Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an OR Registered Nurse PRN you want with your current employer? We...Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Dallas, TX)
- …your career path, we encourage you to apply for our Operating Room Registered Nurse opening. We review all applications. Qualified candidates will be contacted ... have the career opportunities as an Operating Room Registered Nurse you want in your current role? We invest...Spine, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Fort Worth, TX)
- …your career path, we encourage you to apply for our Operating Room Registered Nurse opening. We review all applications. Qualified candidates will be contacted ... have the career opportunities as an Operating Room Registered Nurse you want in your current role? We invest...Surgery, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Plano, TX)
- …next step in your career path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... Do you have the career opportunities as a Registered Nurse Case Manager you want in your current role?...Plano, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Dallas, TX)
- …**Benefits** North Texas Division offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and ... a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and...professionals + Hire and maintain appropriate staffing levels and utilization of personnel and ensure the highest quality of… more
- Fresenius Medical Center (Lewisville, TX)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be… more
- Baylor Scott & White Health (Dallas, TX)
- …Master's degree preferred. 2. 5+ years of experience in case management, social work, utilization review , or related field. 3. 1+ years of experience in a ... management, social services, coordination of patient care, patient access, utilization management, and discharge planning. Directs the management and...- Lic Masters Social Worker -- RN - Registered Nurse . As a health care system committed… more
- Molina Healthcare (Dallas, TX)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... Health , Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. + Experience… more
- Baylor Scott & White Health (Mckinney, TX)
- …Master's degree preferred. 2. 3+ years of experience in case management, social work, utilization review , or related field. 3. Experience in a leadership role ... continuum of care and case management functions of Baylor Scott and White Health (BSWH), which may include , case management, social services, coordination of… more
- Methodist Health System (Dallas, TX)
- …positive clinical outcomes. Quality Initiatives include core measures, physician peer review , OPPE/FPPE, quality indicators such as, but not limited to, PSI's, ... HAC's, complications, mortality and other clinical chart review and special performance improvement projects. Responsibilities include, but are not limited to daily… more
- Molina Healthcare (Dallas, TX)
- …performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff… more