- 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 ... determinations + Recent work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare, Medicaid, and Managed… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …command. Understand and interpret federal regulations, VHA guidelines, medical review criteria, utilization management processes, clinical documentation ... InterQual criteria and conducts InterQual reviews using the National Utilization Management Integration database, successfully passing the Inter-Rater reliability… more
- HCA Healthcare (Houston, TX)
- …The Woman's Hospital of Texas have the opportunity to make a real impact. As a Case Manager Registered Nurse you can be a part of change. **Benefits** The ... and improve positive outcomes for your patients as a Case Manager RN Registered Nurse . We want...in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved… more
- HCA Healthcare (Pasadena, TX)
- …personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified candidates ... Do you have the career opportunities as a(an) Registered Nurse Case Manager you want with your...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
- HCA Healthcare (Houston, TX)
- …personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified candidates ... care like family! Jump-start your career as a(an) Registered Nurse Case Manager today with HCA Houston...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
- HCA Healthcare (Tomball, TX)
- …Tomball we support our colleagues in their positions. Join our Team as a(an) Registered Nurse Case Manager and access programs to assist with every stage of your ... certifications and job skills. Apply today for our Registered Nurse Case Manager opening and continue to...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
- HCA Healthcare (Corpus Christi, TX)
- …Do you want to join an organization that invests in you as a(an) Registered Nurse Case Manager PRN? At Corpus Christi Medical Center, you come first. HCA ... a difference. We are looking for a dedicated Registered Nurse Case Manager PRN like you to...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
- HCA Healthcare (Webster, TX)
- …personal growth, we encourage you to apply for our Registered Nurse RN Case Manager PRN opening. We review all applications. Qualified candidates will be ... you have the PRN career opportunities as a(an) Registered Nurse RN Case Manager PRN you want...supporting a balance of optimal care and appropriate resource utilization **What qualifications you will need:** + Current Registered… more
- HCA Healthcare (Lewisville, TX)
- …Lewisville we support our colleagues in their positions. Join our Team as a Registered Nurse Case Manager PRN and access programs to assist with every stage of ... certifications and job skills. Apply today for our Registered Nurse Case Manager PRN opening and continue...Case Manager PRN opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- CVS Health (Austin, TX)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible… more
- HCA Healthcare (Austin, TX)
- …personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified candidates ... care like family! Jump-start your career as an Registered Nurse Case Manager today with St. David's...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management… more
- HCA Healthcare (Austin, TX)
- …important to you, we encourage you to apply for our Registered Nurse Case Manager opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as a(an) Registered Nurse Case Manager and access programs to...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management… more
- HCA Healthcare (El Paso, TX)
- … Case Manager serves as a liaison between medical staff, administration, utilization review , nursing, finance, medical records and other ancillary departments ... us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Rehabilitation Case Manager to join our healthcare family. **Benefits** Las… more
- HCA Healthcare (Round Rock, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We review all applications. Qualified candidates will be ... you have the PRN career opportunities as a(an) Registered Nurse Case Manager PRN you want with...supporting a balance of optimal care and appropriate resource utilization . **What qualifications you will need:** Education & Experience:… more
- HCA Healthcare (Austin, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We review all applications. Qualified candidates will be ... you have the PRN career opportunities as a(an) Registered Nurse Case Manager PRN you want with...supporting a balance of optimal care and appropriate resource utilization . **What qualifications you will need:** **Education & Experience:**… more
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Actalent (Dallas, TX)
- …Experience in utilization management, concurrent review , prior authorization, utilization review , case management, and discharge planning. + ... Job Title: Review Nurse Job Description The ...Proficiency with InterQual. + Active Compact RN License. + Utilization Management/Concurrent Review experience. + ICU/ER experience.… more
- Molina Healthcare (TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level… more
- Houston Methodist (Sugar Land, TX)
- …timely termination submission, timely timecard approval, etc.). + Supports maximization of Case Mgmt. system utilization , including length of stay (LOS), ... percentage, and other areas according to department specifications. + Manages utilization management (UM) programs including Medical Claims Review ,… more
- Houston Methodist (Houston, TX)
- …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... most clinically appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social… more