- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… 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
- Cognizant (Austin, TX)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Molina Healthcare (Austin, TX)
- …key health care services (HCS) functions: care management , care transitions, utilization management , behavioral health and/or nurse advice line. ... professionals, in some or all of the following functions: utilization management , care management , care...and experience. * At least 5 years health care management /leadership required. * Registered Nurse (RN), Licensed… more
- Centene Corporation (Austin, TX)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...Certified Behavior Analyst (BCBA) required + RN - Registered Nurse - State Licensure and/or Compact State Licensure RN… 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 (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
- 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 (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
- Molina Healthcare (Austin, TX)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… 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
- 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
- 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. ... work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Surgicare of South Austin! **Job… 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
- Fresenius Medical Center (Austin, TX)
- …direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in optimum ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- AccentCare, Inc. (Round Rock, TX)
- …as needed, etc. + Reporting and management of case management model with focus on paraprofessional utilization - including correct ... preferred. Responsibilities: + Daily completion of the following tasks: daily management of KPIs, field staff support, verbal orders, workflow, escalation/complaint… more