- Centene Corporation (Austin, TX)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- HCA Healthcare (Corpus Christi, TX)
- …your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates will be ... **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer PRN you want in...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews… more
- HCA Healthcare (El Paso, TX)
- …medical services and discharge planning for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes ... knowledge of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical … more
- HCA Healthcare (Mcallen, TX)
- …for benefits may vary by location._ **Job Summary and Qualifications** The Review Nurse Clinical Reviewer position encompasses multiple responsibilities ... including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews & is proactive in working with… more
- Texas Health Resources (Dallas, TX)
- …patient populations in terms of operation, services and patient care . Concurrent review of medical records against pre-established criteria/quality initiatives ... **Sepsis Program Coordinator, Registered Nurse ** _Come join our team at Texas Health...identify and measure continuous improvement priorities and targets . Review medical records against pre-established criteria for Sepsis and… more
- Prime Healthcare (Mission, TX)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... one of the top hospitals in the country for clinical excellence in many services including maternity and orthopedic...accredited school of nursing and a current state Registered Nurse license. + Grandfathered prior to April 1, 2015.… more
- HCA Healthcare (Corpus Christi, TX)
- …next step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates ... Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews… more
- Molina Healthcare (Houston, TX)
- …a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Houston Methodist (Baytown, TX)
- …competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, ... leadership to ensure operational effectiveness and efficiency of admission, concurrent and retrospective utilization management and medical claims functions to… more
- MD Anderson Cancer Center (Houston, TX)
- …and research nurse are notified in a timely fashion. Performs ongoing and concurrent review of data to ensure completeness and accuracy. Addresses data entry ... timely manner. Communicates research data revision requests to the physician and/or clinical research staff for correction. Trains other members of research staff on… more
- Houston Methodist (The Woodlands, TX)
- …include the notification of and follow through with the Employee Health Nurse when such contacts have involved Hospital personnel.) + Leads multidisciplinary teams ... practical surveillance program which incorporates the systematic and current review of healthcare associated infections (HAIs), significant communicable diseases,… more
- Houston Methodist (Baytown, TX)
- …include the notification of and follow through with the Employee Health Nurse when such contacts have involved Hospital personnel.) **SERVICE ESSENTIAL FUNCTIONS** + ... practical surveillance program which incorporates the systematic and current review of healthcare associated infections (HAIs), significant communicable diseases,… more
- Molina Healthcare (Dallas, TX)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in… more
- HCA Healthcare (Houston, TX)
- …regulatory projects, including nursing dashboard.** **Position Responsibilities** + **Performs concurrent core measure chart review and retrospective in-depth ... data to appropriate Medical Staff Department meetings.** + **Mortality/complication cases review , provides accurate/reliable clinical analysis to support an… more
- HCA Healthcare (Corpus Christi, TX)
- …staff education to ensure compliance with CMS guidelines.** + **You will conducts concurrent chart review for technical compliance and content to ensure Analyzes ... is required.** + **Licensed professional in Texas in a clinical health care specialty (ie Registered Nurse ,...a clinical health care specialty (ie Registered Nurse , Physical Therapist, Occupational Therapist, or Speech Therapist) is… more
- BrightSpring Health Services (Irving, TX)
- …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... monitoring both skilled and non-skilled healthcare services + Directly supervises clinical personnel + Providing clinical teaching and conducting performance… more
- BrightSpring Health Services (Arlington, TX)
- …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... monitoring both skilled and non-skilled healthcare services + Directly supervises clinical personnel + Providing clinical teaching and conducting performance… more
- Prime Healthcare (Harlingen, TX)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... accredited school of nursing and a current state Registered Nurse license. + Grandfathered prior to April 1, 2015....of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. +… more