- PharmaCord (Austin, TX)
- … Utilization Management, Call Center Case Management, a plus. Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are ... independently while collaborating to share ideas, support, and resources. As a Nurse Advocate you are responsible for contact with program patients and assessing… more
- Cognizant (Austin, TX)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… 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 ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- CVS Health (Austin, TX)
- …/benefit management function. **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure ... it all with heart, each and every day. Medicare Clinical Predetermination Nurse **Must be willing and...(AFTER training M-F for about 4 - 5 months).** ** Utilization Management is a 24/7 operation and work schedules… more
- CVS Health (Austin, TX)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- HCA Healthcare (Austin, TX)
- …South 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. ... improve positive outcomes for your patients as a (an) Registered Nurse Case Management. We want your...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for… more
- HCA Healthcare (Round Rock, TX)
- …nurses set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** St. ... life - and empowers their passion for patient care. Apply today for our Registered Nurse Case Manager opportunity. **Job Summary and Qualifications** The … more
- CVS Health (Austin, TX)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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 ... at St. David's Round Rock Medical Center! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care by… more
- Baylor Scott & White Health (Lakeway, TX)
- **JOB SUMMARY** The Registered Nurse (RN) Seasonal PRN is a licensed professional who uses the BSWH nursing professional practice model to coordinate patient ... competencies of the employee. **ESSENTIAL FUNCTIONS OF THE ROLE** Clinical Judgment: Using clinical reasoning, conducts accurate...- 1 Year of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse (RN) & Basic Life Support… 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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- CVS Health (Austin, TX)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Evolent (Austin, TX)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... 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… more
- Molina Healthcare (Austin, TX)
- …and/or coding experience, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities....or modification of payment decisions. * Serves as a clinical resource for utilization management, chief medical… more
- Sharecare (Austin, TX)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Lincoln Financial (Austin, TX)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... 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… more
- Molina Healthcare (Austin, TX)
- …skills. + Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** + Registered Nurse (RN). The license must be active and ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- Molina Healthcare (Austin, TX)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary... Practitioner will be required to work primarily in non- clinical settings and provide medical care to all levels… more
- Molina Healthcare (Austin, TX)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
