- Actalent (Dallas, TX)
- Job Title: Review Nurse Job Description The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical necessity for ... successful completion of cases. Essential Skills + Experience in utilization management, concurrent review , prior authorization, utilization review , case… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- HCA Healthcare (Austin, TX)
- …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... in their positions. Join our Team as a(an) Registered Nurse Trauma Performance Coordinator and access programs to assist...and Patient Safety (PIPS) Program. The PI Coordinator will review the continuum of care to determine compliance with… more
- HCA Healthcare (Tomball, TX)
- …Tomball we support our colleagues in their positions. Join our Team as a Nurse Manager RN Women's Services and access programs to assist with every stage of ... gain certifications and job skills. Apply today for our Nurse Manager RN Women's Services opening and continue to...relationships across the hospital** + **Ability to manage multiple concurrent projects and maintain a work pace appropriate to… more
- HCA Healthcare (Conroe, TX)
- …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... you passionate about delivering patient-centered care?** Submit your application for Registered Nurse Trauma Coordinator position and spend more time at the bedside… more
- HCA Healthcare (Houston, TX)
- …Registered Nurse Clinical Reviewer opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. ... in their positions. Join our Team as a(an) Registered Nurse Clinical Reviewer and access programs to assist with...resource to Hospital and Medical Staff + Responsible for concurrent audits of patient charts. Inputs data for tracking,… more
- AdventHealth (Burleson, TX)
- …winning facility and departments including Great Place to Work by Beckers Hospital Review and Gallup. + Work with the latest technology and top experts including ... trauma protocols and guidelines are being followed by observation and chart review . Reviews trauma team activations and assesses for appropriateness based on… more
- Centene Corporation (Austin, TX)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... HAVE WASHINGTON STATE BEHAVIORAL HEALTH LICENSURE **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Houston Methodist (Sugar Land, 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
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... charts and records to evaluate care concurrent with patients' treatment. Reviews treatment plans and status...insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use… more
- Centene Corporation (Houston, TX)
- …weight, current and past medical history, clinical laboratory results and concurrent medications (including over-the-counter or home remedy medications) + Ensure ... and the results are obtained and discussed with the nurse and the physician + Provide patient counseling, education,...+ Assess responses to therapy, patient compliance, and ongoing review of drug regimens; report and manage adverse events… more
- Medical Center Hospital (Odessa, TX)
- …interprofessional care plan, and communication of individual patient needs. Conducts initial, concurrent , and retrospective review functions in support of the ... Position Summary: The Case Manager Nurse is responsible for leading the interprofessional team...LVN or RN with the Texas State Board of Nurse is required. Bachelor's Degree in Nursing preferred. Training… more
- Medical Center Hospital (Odessa, TX)
- …interprofessional care plan, and communication of individual patient needs. Conducts initial, concurrent , and retrospective review functions in support of the ... Position Summary: The Case Manager Nurse is responsible for leading the interprofessional team...LVN or RN with the Texas State Board of Nurse is required. Bachelor's Degree in Nursing preferred. Training… more
- HCA Healthcare (Austin, TX)
- …of medical services and discharge planning for specified patient populations. Performs concurrent and retrospective review of patient medical records for ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...purposes of utilization review , care coordination compliance with requirements of external … more
- Molina Healthcare (Fort Worth, TX)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... Public Health, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. + Experience… more
- HCA Healthcare (Round Rock, TX)
- …and internal committees. What you will do in this position: . Perform daily concurrent chart review to ensure compliance with evidence-based program measures for ... program - required License and Certifications . Current State of Texas Registered Nurse (RN) license or Compact Registered Nursing License. If Compact License Texas… more
- Baylor Scott & White Health (Waco, TX)
- …promote positive patient outcomes. **Essential Functions of the Role** + Performs concurrent and retrospective medical record review to investigate quality ... to appropriately prioritize tasks to meet desired deadlines. + Licensed Registered Nurse strongly preferred **Belonging Statement** We believe that all people should… more
- Baylor Scott & White Health (Dallas, TX)
- …statutes, policies, and procedures. **Essential Functions of the Role** + Performs concurrent and retrospective medical record review to investigate quality ... tasks to meet desired deadlines + Licensed clinician such as nurse , physical therapist, occupational therapist, dietitian, respiratory therapist, etc. preferred.… more
- Triple C - The A&E Group (Dallas, TX)
- …specification production, and client and vendor accessibility. The TD may work on several concurrent projects and at times may assist as a technical expert on a ... include preparation of engineering drawings, specifications, reports, site visits, review of technical documents, and participation in client contact situations.… more