- Humana (Austin, TX)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with no… more
- Baylor Scott & White Health (Austin, TX)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Texas Health Resources (Arlington, TX)
- ** RN / Registered Nurse - Utilization Management , Clinical Reviews** **Work location:** 100% remote but must live in Texas, preferably in the Dallas-Fort ... of medical necessity criteria preferred **Licenses and Certifications** + RN - Registered Nurse Current...each initial review via CareConnect1 or other Utilization Management tool. Discusses working DRG issues… more
- Actalent (San Antonio, TX)
- …Qualifications: + Active Compact RN License in Texas + Prior Utilization management /Concurrent review experience + Acute care experience (ER/ICU) ... Actalent is hiring fully remote Concurrent Review RNs! *Must be located in Texas* Job Description: + Reviewing authorization requests + Utilizing evidence-based… more
- 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...in this role:** + Assumes responsibility for the efficient management of patient in the immediate post anesthesia period.… more
- 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 (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...in this role: + Assumes responsibility for the efficient management of patient in the immediate post anesthesia period.… more
- Prime Healthcare (Weslaco, TX)
- …#registerednurse #casemanagement Connect With Us! (https://careers-primehealthcare.icims.com/jobs/188814/ registered - nurse -case-manager utilization - ... Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
- Molina Healthcare (Houston, TX)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
- Moore County Hospital District (Dumas, TX)
- …education as needed. Alternates with team members to provide weekend case management coverage. EDUCATIONAL/EXPERIENCE REQUIREMENTS: Registered Nurse with ... the last 12 months. Preferred clinical experience in case management or utilization review . REQUIREMENTS...REQUIREMENTS Current CPR LICENSURE / CERTIFICATION REQUIREMENTS: Current Texas RN license or RN compact licensure. OTHER… more
- Actalent (Texas City, TX)
- Job Title: Review Nurse Job Description The ...InterQual. + Active TX RN License. + Utilization Management /Concurrent Review experience. + ... to ensure the successful completion of cases. Essential Skills + Experience in utilization management , concurrent review , prior authorization, utilization… more
- UTMB Health (Friendswood, TX)
- …ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical ... manner. **_ESSENTIAL JOB FUNCTIONS_** **:** + Supervises the operational management of the Utilization Review /Case...Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum… more
- Fresenius Medical Center (Edinburg, 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
- HCA Healthcare (El Paso, TX)
- … Case Manager opening and continue to learn! **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is responsible for promoting patient-centered ... colleagues in their positions. Join our Team as a(an) Registered Nurse Case Manager and access programs...Nurse Case Manager opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- HCA Healthcare (Weatherford, TX)
- …City Weatherford we support our colleagues in their positions. Join our Team as a Registered Nurse Case Manager PRN and access programs to assist with every ... gain certifications and job skills. Apply today for our Registered Nurse Case Manager PRN opening and...up weekday and weekend shifts as needed *_ Our RN Case Managers raise the bar by providing clinical… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- Summary As the Community Care (CC) Coordinator Registered Nurse ( RN ) you will be responsible for executing a streamlined approach to receiving, triaging, and ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- HCA Healthcare (Corpus Christi, TX)
- …Medical Center we support our colleagues in their positions. Join our Team as a(an) Registered Nurse Case Manager PRN and access programs to assist with every ... gain certifications and job skills. Apply today for our Registered Nurse Case Manager PRN opening and...preferred + Current Texas licensure with State Board of Nurse Examiners as an RN + 1+… more
- 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 (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 (El Paso, TX)
- …of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical ... colleagues in their positions. Join our Team as a(an) Registered Nurse Case Manager PRN and access...review of patient medical records for purposes of utilization review , compliance with requirements of external… more