• Christus Health (Irving, TX)
    DescriptionSummary: The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper ... and vendors to obtain approved certification for services. The Utilization Review Nurse collaborates as... collaborates as necessary with other members of the health care team to ensure the above according to… more
    JobGet (01/12/25)
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  • Utilization Review - Case…

    Methodist Health System (Celina, TX)
    …respective agency for non- nurse professional * 2 years or more of health care experience; minimum 1 year acute hospital experience * Acute hospital case ... engaged and eager to build a winning team Methodist Health System is a faith-based organization with a mission...compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for … more
    Methodist Health System (01/11/25)
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  • Utilization Management Representative I

    Elevance Health (Grand Prairie, TX)
    …prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification ... **Title: Utilization Management Representative I** **Location:** This position will...responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing… more
    Elevance Health (01/07/25)
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  • Nurse Manager - GI Lab

    Texas Health Resources (Plano, TX)
    ** Nurse Manager - GI Lab** _Are you looking for...for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health Plano ... + Core work hours: Monday-Friday 8:00a - 5:00p Since 1991, Texas Health Plano has served the communities of Plano, Frisco, Carrollton, Addison, Richardson and… more
    Texas Health Resources (12/19/24)
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  • Nurse Manager I - Neuro Trauma ICU

    Texas Health Resources (Dallas, TX)
    ** Nurse Manager Nureo Trauma ICU** _Are you looking...for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health ... Dallas + Core work hours: Monday-Friday 8:00a-5:00p For more than a half-century, Texas Health Presbyterian Hospital Dallas has been at the forefront of health more
    Texas Health Resources (11/30/24)
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  • Nurse Manager - GI Lab & Ambulatory Care…

    Texas Health Resources (Flower Mound, TX)
    ** Nurse Manager - GI lab and ACU** _Are you...for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health Flower ... services and outpatient surgery to giving birth and routine check-ups, Texas Health Presbyterian Hospital Flower Mound is committed to comprehensive healthcare. Our… more
    Texas Health Resources (12/30/24)
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  • Nurse Manager I-Labor and Delivery

    Texas Health Resources (Fort Worth, TX)
    ** Nurse Manager I-Labor and Delivery** _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified ... candidates like you to join our Texas Health family._ **Texas Health Southwest Fort Worth**...this purpose. Provide resources and guidance to support the utilization of evidence based practice standards. Identify and utilize… more
    Texas Health Resources (12/05/24)
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  • Nurse Reviewer I (US)

    Elevance Health (Grand Prairie, TX)
    …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
    Elevance Health (01/08/25)
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  • Operating Room Registered Nurse

    HCA Healthcare (Dallas, TX)
    …any other healthcare provider. We are seeking an Operating Room Registered Nurse to join our healthcare family. **Benefits** Park Central Surgical Center, offers ... a total rewards package that supports the health , life, career and retirement of our colleagues. The...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
    HCA Healthcare (11/23/24)
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  • PRN OR Registered Nurse

    HCA Healthcare (Allen, TX)
    …and personal growth, we encourage you to apply for our PRN OR Registered Nurse opening. We review all applications. Qualified candidates will be contacted for ... have the career opportunities as a PRN OR Registered Nurse you want with your current employer? We have...Allen offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
    HCA Healthcare (10/29/24)
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  • OR Registered Nurse PRN

    HCA Healthcare (Dallas, 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 (12/05/24)
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  • OR Registered Nurse PRN

    HCA Healthcare (Dallas, 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 ... you have the career opportunities as a 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 (10/23/24)
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  • Operating Room Registered Nurse

    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 (10/29/24)
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  • Operating Room Registered Nurse

    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 (10/29/24)
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  • Clinical Manager Home Health Full Time

    CenterWell (Grapevine, TX)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... part of our caring community and help us put health first** + Develops, plans, implements, analyzes, and organizes...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
    CenterWell (11/16/24)
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  • Director Care Management

    Methodist Health System (Dallas, TX)
    …of anticipated impact of external regulations and cost-containment efforts related to Utilization Review , Case Management. * Attains all agreed to goals ... required. * Master's degree in Nursing, Health Care Administration, Public Health , Business Administration, preferred. * Registered nurse graduated from an… more
    Methodist Health System (01/01/25)
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  • Medical Director

    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 ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
    Molina Healthcare (12/26/24)
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  • Case Coordinator - Denials

    Methodist Health System (Dallas, TX)
    …initiatives while supporting the mission, vision, value and strategic goals of Methodist Health System. Your Requirements: * Bachelors of Science degree in Nursing - ... REQUIRED for Nursing professionals * Current license from respective agency for non- nurse professionals- PREFERRED * CCM in Case Management - PREFERRED Your… more
    Methodist Health System (01/11/25)
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  • Home Health Clinical Manager

    HCA Healthcare (Irving, TX)
    **Description** **Introduction** We are seeking a Home Health Clinical Manager with Medical City Healthcare at Home to promote growth and unlock possibilities. At ... City Healthcare at Home, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and programs… more
    HCA Healthcare (01/09/25)
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  • Care Transition Navigator FT

    Methodist Health System (Richardson, TX)
    …planning while supporting a balance of optimal care and appropriate resource utilization . The Care Transitions Navigator will identify potential barriers to patient ... Social Work; Texas Social Work license required * Registered Nurse with BSN preferred * 1 year of experience...with BSN preferred * 1 year of experience in health related setting * Hospital case management experience preferred… more
    Methodist Health System (12/21/24)
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