- Humana (Austin, TX)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- HCA Healthcare (Austin, TX)
- …Austin Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse Case Management you can be a part of change. **Benefits** St. David's ... positive outcomes for your patients as a (an) Registered Nurse Case Management . We want your knowledge...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management … more
- Sharecare (Austin, TX)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- HCA Healthcare (Round Rock, TX)
- …us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** St. David's Round Rock ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- Molina Healthcare (Austin, TX)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... must be technologically proficient, self-directed, autonomous and experience working from home . Care Management & Waiver Service Auditing experience is… more
- HCA Healthcare (Round Rock, TX)
- **Description** **Introduction** Do you have the career opportunities as a Registered Nurse Case Manager you want in your current role? We invest in what matters ... most to nurses like you - at home , at work, and at every stage in your...Rock Medical Center! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care… more
- Evolent (Austin, TX)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- HCA Healthcare (Austin, TX)
- …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse position and spend more time at the bedside with the patient. ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- CenterWell (Austin, TX)
- …+ Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment. **Scheduled Weekly ... patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission… more
- Molina Healthcare (Austin, TX)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Molina Healthcare (Austin, TX)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Molina Healthcare (Austin, TX)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- HCA Healthcare (Austin, TX)
- … Nurse in transplant services + Minimum 3 years' experience in Case Management / Utilization Education + Graduate of an accredited school of nursing, BSN ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Centene Corporation (Austin, TX)
- …Licensure required or + NP - Nurse Practitioner - Current State's Nurse Licensure required + For Superior: Resource Utilization Group (RUG) certification ... care, transportation, activities for daily living) + May perform home and/or other site visits (eg, once a month...Postpartum, Pediatric ER, Pediatric Private Duty Nursing, or School Nurse + Case Management + Service Coordination… more
- HCA Healthcare (Round Rock, TX)
- …labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Sharecare (Austin, TX)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- HCA Healthcare (Austin, TX)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... + Referral services for child, elder and pet care, home and auto repair, event planning and more +...performing duties in multiple physical locations. Works with clinical, management , and other support personnel to coordinate both on… more
- HCA Healthcare (Austin, TX)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... + Referral services for child, elder and pet care, home and auto repair, event planning and more +...Qualifications** The Manager of Cardiovascular Services provides leadership and management to all personnel within an assigned units. The… more