• Utilization Review RN

    Catholic Health Initiatives (Houston, TX)
    …be required to perform other duties as assigned. **Qualifications** **Required:** -Associate's Degree - Registered Nurse ( RN ) -Two (2) years of experience ... -Knowledge of case management, working of Medicare, Medicaid and private insurance -Ability to interact professionally with case management staff, physicians and payers + If offered the position, you will have 90 days to pass the MCG competency test. However,… more
    Catholic Health Initiatives (01/11/25)
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  • Care Review Clinician, Inpatient…

    Molina Healthcare (Houston, TX)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... care/medical experience. R **equired License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must have… more
    Molina Healthcare (12/22/24)
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  • Program Mgr UR/Case Management - CMC - Baybrook

    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
    UTMB Health (12/20/24)
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  • UM Reviewer

    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
    Apex Health Solutions (12/08/24)
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  • RN Clinical Manager, Home Health

    CenterWell (League City, TX)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (12/20/24)
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  • Registered Nurse RN PACU PRN

    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 (11/01/24)
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  • Registered Nurse RN Pre-Admit…

    HCA Healthcare (Houston, TX)
    …you, we encourage you to apply for our Registered Nurse RN Pre-Admit opening. Our team will promptly review your application. Highly qualified candidates ... colleagues in their positions. Join our Team as a(an) Registered Nurse RN Pre-Admit and...including response to hospital codes. + Proficient in the utilization of specialized skills to provide care to patients… more
    HCA Healthcare (12/20/24)
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  • Registered Nurse RN Case…

    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 (12/15/24)
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  • Registered Nurse RN PACU…

    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
    HCA Healthcare (11/06/24)
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  • Director, Case Management & Social Services

    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
    Houston Methodist (12/22/24)
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  • Supervisor Registered Nurse Case…

    HCA Healthcare (Houston, TX)
    …appropriate. **What qualifications you will need:** + Bachelor's degree Nursing preferred + Registered Nurse - Currently licensed as a registered ... needs. + Accountable for reviewing, monitoring and reporting hospital utilization of resources through concurrent review according...Support + Registered Social Worker (RSW), or Registered Nurse , or Certified Care Manager (CMC)… more
    HCA Healthcare (11/27/24)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Humble, 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
    Fresenius Medical Center (12/31/24)
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  • Registered Nurse Emergency…

    HCA Healthcare (Conroe, TX)
    …growth, we encourage you to apply for our Registered Nurse RN Emergency Department PRN opening. We review all applications. Qualified candidates will be ... Do you have the PRN career opportunities as a(an) Registered Nurse RN Emergency Department...of peak activity and reduced work load for maximum utilization of time. + Utilizes communication skills maximally in… more
    HCA Healthcare (12/06/24)
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  • Registered Nurse Case Manager

    HCA Healthcare (Houston, 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 a(an) Registered Nurse Case Manager today with HCA...preferred + Current Texas licensure with State Board of Nurse Examiners as an RN + 1+… more
    HCA Healthcare (12/15/24)
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  • Registered Nurse Case Manager

    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
    HCA Healthcare (01/07/25)
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  • Registered Nurse -In Home Primary…

    The Cigna Group (Houston, TX)
    The RN serves as the key contact point for the...as needed 3) 3+ years of experience as a Registered Nurse with experience in internal medicine or ... coordinate and streamline all services offered within Evernorth. The RN will educate the patient on healthcare options, provide...and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all… more
    The Cigna Group (11/22/24)
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  • Registered Nurse - In Home Primary…

    The Cigna Group (Houston, TX)
    The RN Coordinator serves as the key contact point for...as needed 3) 3+ years of experience as a Registered Nurse 4) Proficient level of experience with ... and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all...of the team to manage heath care cost and utilization **Provider Support** 1. Completes telephonic nursing assessments including… more
    The Cigna Group (12/18/24)
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  • Clinical Documentation Specialist

    Houston Methodist (Houston, TX)
    …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
    Houston Methodist (12/09/24)
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  • System Float Pool - Case Manager RN (PRN)

    Houston Methodist (Houston, TX)
    …Houston Methodist, the System Float Pool Case Manager (CM) Certified position is a registered nurse ( RN ) responsible for comprehensively planning for case ... engagement, ie, peer-to-peer accountability. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (12/24/24)
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  • Case Manager ( RN ) - PRN

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a target ... department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (12/06/24)
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