- Humana (Austin, TX)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Humana (Austin, TX)
- …independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review cases using clinical knowledge, ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- ERP International (Corpus Christi, TX)
- … utilization management services including referrals, care coordination, utilization review , discharge planning, continued stay reviews, and appeal ... **Overview** ERP International is seeking a **Registered Nurse (RN)** ** Utilization Manager** for a...as appropriate. * Participate in all phases of the Utilization Management Program (UMP) and ensure that… more
- Conviva (Austin, TX)
- …+ Prior clinical experience, managed care experience, Home Health, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to ... care services requiring authorization prior to services being rendered for members. The Utilization Review Specialist (LVN) serves as a liaison in reviewing… more
- UTMB Health (Galveston, TX)
- Utilization Review Case Mgr. - Galv. Campus Utilization Mgmt. (M- F / 8a- 5p) **Galveston, Texas, United States** **New** Nursing & Care Management UTMB ... the use of medical services, procedures, and facilities. Supports the UTMB Utilization Management Program utilizing clinical knowledge, expertise, and criteria… more
- Ascension Health (Austin, TX)
- … Review RN, you'll provide health care services regarding admissions, case management , discharge planning and utilization review . + Review ... **Details** + **Department:** Utilization Review + **Schedule:** Full-time, 8-hour...coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure… more
- Lincoln Financial Group (Austin, TX)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Centene Corporation (Austin, TX)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- ChenMed (Houston, TX)
- …of 2 years' clinical work experience required. + A minimum of 1 year of utilization review and/or case management , home health, hospital discharge planning ... great people to join our team. The Acute Care Nurse is responsible for achieving positive patient outcomes, managing...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
- Houston Methodist (Houston, TX)
- …thinking skills and clinical judgment to work autonomously as defined by the Nurse Practice Act. + Demonstrates proficient time management skills. + Demonstrates ... At Houston Methodist, the Charge Nurse position is a licensed professional Registered ...clinical practice. This position creates an environment for the management and delivery of safe patient care. In addition… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …that the access, quality of care, customer service, patient satisfaction and utilization management , efficiency dimensions of care are continuously evaluated and ... The Assistant Chief of Behavioral Health is responsible for the oversight and management of personnel in Behavioral Health Service. The incumbent ensures that staff… more
- HCA Healthcare (Houston, TX)
- …patient needs. + Accountable for reviewing, monitoring and reporting hospital utilization of resources through concurrent review according to pre-established ... any other healthcare provider. We are seeking a(an) Case Management Supervisor RN to join our healthcare family. **Benefits**...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… 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 ... in their positions. Join our Team as a(an) Registered Nurse Case Manager PRN and access programs to assist...review of patient medical records for purposes of utilization review , compliance with requirements of external… more
- The Cigna Group (Harlingen, TX)
- …Nursing. * Three to Five (3-5) years recent experience in an acute-care environment, case- management or utilization management position (experience can be a ... skills * Typing and computer knowledge- able to type 35WPM * Knowledge of utilization review requirements and procedures * Knowledge of current health care… more
- HCA Healthcare (Tomball, TX)
- …satisfaction and personal growth, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We promptly review all applications. Highly ... Do you have the career opportunities as a(an) Registered Nurse Case Manager PRN you want with your current...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
- HCA Healthcare (Houston, TX)
- …satisfaction and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... integrity. We care like family! Jump-start your career as a(an) Registered Nurse Case Manager today with HCA Houston Healthcare Northwest. **Benefits** HCA Houston… more
- HCA Healthcare (Pasadena, TX)
- …you find this opportunity compelling, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We promptly review all applications. Highly ... where diversity and inclusion thrive? Submit your application for our Registered Nurse Case Manager PRN opening with HCA Houston Healthcare Southeast today and… more
- HCA Healthcare (Corpus Christi, TX)
- …satisfaction and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... Do you have the career opportunities as a(an) Registered Nurse Case Manager you want with your current employer?...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
- HCA Healthcare (Kingwood, TX)
- …find this opportunity compelling, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... where diversity and inclusion thrive? Submit your application for our Registered Nurse Case Manager opening with HCA Houston Healthcare Kingwood today and find… more