- PharmaCord (Austin, TX)
- …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... collaborating to share ideas, support, and resources. As a Nurse Advocate you are responsible for contact with program...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… more
- Humana (Austin, TX)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Austin, TX)
- …work S/S/M/T 10 hour shifts (AFTER training M-F for about 4 - 5 months).** ** Utilization Management is a 24/7 operation and work schedules will include holidays ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...or eastern time zone (AFTER 4-5 months of training). Utilization Management is a 24/7 operation and… more
- CVS Health (Austin, TX)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in central time zones… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Austin, TX)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Lincoln Financial (Austin, TX)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... 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
- CVS Health (Austin, TX)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Sharecare (Austin, TX)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- HCA Healthcare (Austin, TX)
- …Austin Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse Case Management you can be a part of change. **Benefits** St. David's ... positive outcomes for your patients as a (an) Registered Nurse Case Management . We want your knowledge...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- CVS Health (Austin, TX)
- …in managed care, clinical, or health care related field. - 1 year of project management experience. - Registered Nurse (RN) license in the state of their ... in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides training and… more
- CVS Health (Austin, TX)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Molina Healthcare (Austin, TX)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, ... are most receptive including home, nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and… more
- HCA Healthcare (Round Rock, TX)
- …us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** St. David's Round Rock ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- Molina Healthcare (Austin, TX)
- …post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings ... states besides home state based on business need. * Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and… more
- Molina Healthcare (Austin, TX)
- …of payment decisions. * Serves as a clinical resource for utilization management , chief medical officers, physicians and member/provider inquiries/appeals. ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims payment… more
- HCA Healthcare (Round Rock, TX)
- **Description** **Introduction** Do you have the career opportunities as a Registered Nurse Case Manager you want in your current role? We invest in what matters ... Round Rock Medical Center! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care by coordinating… more
- Evolent (Austin, TX)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
