- HealthCare Support (Houston, TX)
- Utilization Review RN HealthCare Support is...in Remote Houston TX . Daily Responsibilities for Utilization Review RN : WIll need to ... actively seeking a Utilization Review RN to fill an opening with a Prestigious HealthCare Company… more
- Conifer Revenue Cycle Solutions (Frisco, TX)
- …(2) years supervisory experience CERTIFICATES, LICENSES, REGISTRATIONS Preferred: Active state Registered Nurse license or Certified Coding Specialist credential ... annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding… more
- Cognizant (Austin, TX)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- CVS Health (TX)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Humana (Austin, TX)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Texas Health Resources (Arlington, TX)
- … Management required 3 years previous leadership experience required Licenses and Certifications RN - Registered Nurse Current license to practice ... Director Utilization Management-Clinical Review _Are you looking...Core work hours: Monday-Friday 8:00a-5:00p. This position is hybrid remote /onsite. Vast majority of time will be remote… more
- Centene Corporation (Austin, TX)
- …related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or ... perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review … more
- Molina Healthcare (San Antonio, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
- Sharecare (Austin, TX)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Apex Health Solutions (Houston, TX)
- …will consider remote deployment on a case by case basis Education Education: Registered Nurse ( RN ) LICENSES/CERTIFICATIONS: Registered Nurse ( ... communication skill Some travel in the Houston metro area may be required Remote deployment will be considered SKILLS Knowledge of healthcare delivery Ability to… more
- Health Care Service Corporation (Richardson, TX)
- …appropriate for treatment within the Autism Spectrum Diagnoses (ASD). **JOB REQUIREMENTS:** ** Registered Nurse ( RN ) or Masters-level Behavioral Health ... decision making skills.** **PC and database experience.** **PREFERRED JOB REQUIREMENTS:** ** Utilization review experience.** **3 years clinical experience in… more
- HCA Healthcare (Dallas, TX)
- …(RRT / RCP), or State Registered Respiratory Therapist, or Occupational Therapy (OT), or ( RN ) Registered Nurse + 2 years of clinical experience in an ... rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong clinical evidence to… more
- Highmark Health (Austin, TX)
- …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year ... **Required** + None **Preferred** + PA clinical licensure/certifications such as RN , RD, Pharmacist **Language (Other than English):** None **Travel Requirement:**… more
