- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Ascension Health (Austin, TX)
- **Details** + **Department:** Utilization Review + **Schedule:** PRN Day shift + **Location:** Remote - Must live within 60 miles of Texas Administrative Offices ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… more
- Adecco US, Inc. (Houston, TX)
- Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This role is in person / on site. Please read below ... 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . **...* Bachelors' degree in nursing preferred * Current, unrestricted RN License in Texas . 2 to 3 years… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case management, which includes ... clinical experience + Case management experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or… more
- Catholic Health Initiatives (Houston, TX)
- …be required to perform other duties as assigned. **Qualifications** **Required:** -Associate's Degree - Registered Nurse ( RN ) -Two (2) years of experience ... -Knowledge of case management, working of Medicare, Medicaid and private insurance -Ability to interact professionally with case management staff, physicians and payers + If offered the position, you will have 90 days to pass the MCG competency test. However,… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Molina Healthcare (San Antonio, TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... care/medical experience. R **equired License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. MULTI… more
- BAYADA Home Health Care (Austin, TX)
- …your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...Manager with OASIS and Coding certification to work remotely. RN , PT, OT, and SLP's with certifications will be… more
- HCA Healthcare (Austin, TX)
- …in your career path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Case Manager you want in...license Preferred: + Certification in case management, nursing, or utilization review preferred. St. David's North Austin… more
- UTMB Health (Friendswood, TX)
- …from an accredited school of Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum of five (5) years full-time wage ... quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical...earning experience as a professional nurse in a healthcare setting with at least two… more
- CVS Health (Austin, TX)
- …care. - Perform medical necessity reviews. **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) 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
- CVS Health (Austin, TX)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) 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
- ChenMed (Houston, TX)
- …RN with Bachelor Degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
- HCA Healthcare (El Paso, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Rehabilitation Case Manager to join our healthcare family. **Benefits** ... - and empowers their passion for patient care. Apply today for our Registered Nurse Rehabilitation Case Manager opportunity. **Job Summary and Qualifications**… more
- Centene Corporation (San Antonio, TX)
- …+ LPN - Licensed Practical Nurse - State Licensure is required + RN - Registered Nurse - State Licensure and/or Compact Nursing Licensure ... 3+ years' of direct patient care experience as a Registered Nurse ( RN ) in Acute...and appropriate level of care + Knowledge of Concurrent Review , Utilization Management processes, Medicare, Medicaid, and… more
- HCA Healthcare (Houston, TX)
- …growth, we encourage you to apply for our Registered Nurse RN PACU PRN opening. We review all applications. Qualified candidates will be contacted ... Do you have the PRN career opportunities as a(an) Registered Nurse RN PACU PRN...all practices in the PACU. + Proficient in the utilization of specialized skills to provide care to patients… more
- HCA Healthcare (San Antonio, TX)
- …Bachelor of Science in Nursing Prefer at least one year experience in utilization review , resource management, discharge planning or case management. Methodist ... needs of the patient population served (if applicable). Required: RN License to practice as a professional registered...personal growth, we encourage you to apply for our RN Case Manager PRN opening. We review … more
- Fresenius Medical Center (Lewisville, TX)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Fresenius Medical Center (Humble, TX)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Children's Home Healthcare (Richardson, TX)
- …authorizations for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional ... * RN LICENSE REQUIRED, DO NOT APPLY IF YOU...on a 60 days basis per company policy. 9. Review /approve plan of care and all related documents prior...CPR + At least 2 years experience as a Registered Nurse + At least 1 year… more