- 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
- CVS Health (Austin, TX)
- …and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management/ review experience preferred Outpatient Clinical experience. + Knowledge of… 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 (Austin, TX)
- …reliable transportation. **Preferred Experience** Previous experience in ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… 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
- 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)
- …- 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
- Fresenius Medical Center (Austin, 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
- Molina Healthcare (Austin, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
- Sharecare (Austin, TX)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… 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 ... Do you have the PRN career opportunities as a Registered Nurse Case Manager PRN you want...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for… more
- HCA Healthcare (Round Rock, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... Do you have the PRN career opportunities as a Registered Nurse Case Manager you want with...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for… more
- CVS Health (Austin, TX)
- …it all with heart, each and every day. **Summary** : The Care Manager Registered Nurse ( RN )/Service Coordinator is responsible for driving and supporting care ... care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CM RN utilizes advanced clinical judgment and critical thinking skills to… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with ... access the full range of their benefits through the utilization review process. Requirements + Education: Master's...LMFT or LMFT-A Preferred but not required. LVN or RN licensure also considered for this position. + Experience:… more
- Molina Healthcare (Austin, TX)
- …abuse through the identification of aberrant coding and/or billing patterns through utilization review . * Incorporate leadership and communication skills to work ... care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED… more
- HCA Healthcare (Austin, TX)
- …Science in Nursing (BSN) - preferred Licenses and Certifications . Current State of Texas Registered Nurse ( RN ) license or Compact Registered Nursing ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...the patient flow program effectiveness as it relates to utilization review , resource management, and discharge planning… more
- Lincoln Financial (Austin, TX)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
- Evolent (Austin, TX)
- …+ Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of ... direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + **Cardiology and Oncology… more
- Home Care Providers of Texas (Leander, TX)
- Seeking Registered Nurse in the Leander/Austin, TX area! Zip Code 78641 Monday - Friday 8am - 5pm Sign on Bonus offered Have you ever felt overwhelmed at your ... to meet the needs of each individual patient. + Responsible for evaluating utilization of patient services and patient progress. Review evaluation with the… more