- 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 assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… 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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- CVS Health (Austin, TX)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Austin, TX)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- HCA Healthcare (Austin, TX)
- …South 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. ... improve positive outcomes for your patients as a (an) Registered Nurse Case Management. We want your...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for… 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 ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Baylor Scott & White Health (Lakeway, TX)
- **JOB SUMMARY** The Registered Nurse (RN) Seasonal PRN is a licensed professional who uses the BSWH nursing professional practice model to coordinate patient ... competencies of the employee. **ESSENTIAL FUNCTIONS OF THE ROLE** Clinical Judgment: Using clinical reasoning, conducts accurate...- 1 Year of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse (RN) & Basic Life Support… more
- CVS Health (Austin, TX)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Centene Corporation (Austin, TX)
- …required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required + For ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Evolent (Austin, TX)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... 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… more
- Sharecare (Austin, TX)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Molina Healthcare (Austin, TX)
- …for denial or modification of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and ... of Nursing **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or… more
- CVS Health (Austin, TX)
- …or health care related field. - 1 year of project management experience. - Registered Nurse (RN) license in the state of their residence. **Education** Bachelors ... in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides… more
- CenterWell (Austin, TX)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... health first** + Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. + Conducts/delegates...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Molina Healthcare (Austin, TX)
- …* At least 3 years health care management/leadership experience. * Registered Nurse (RN) or other advanced clinical or medical licensure. License must be ... active and unrestricted in state of practice. * Deep understanding of clinical operations: utilization management, care management, etc. * Ability to provide… more
- Molina Healthcare (Austin, TX)
- …behavioral health, or equivalent combination of relevant education and experience. + Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed ... DESCRIPTION** **Job Summary** This position will be focused on Clinical Program Design. Provides subject matter expertise and leadership...5 years of health care experience, including experience in clinical operations, and at least 3 or more years… more
- HCA Healthcare (Austin, TX)
- …we are proud to be the only FACT accredited facility in Austin, Texas. As a Registered Nurse (RN) on the TCT unit you will be responsible for the care ... provides stem cell transplants, Car T cell therapy and clinical trials, with a focus on providing exceptional care...Requirements Experience Preferred + Minimum 3 years' experience as Registered Nurse in transplant services + Minimum… more
- Molina Healthcare (Austin, TX)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Baylor Scott & White Health (Buda, TX)
- …will be evenly distributed among the team. **JOB SUMMARY** The Operating Room (OR) Registered Nurse (RN) Charge is a licensed professional who uses the BSWH ... from the designated manager. **ESSENTIAL FUNCTIONS OF THE ROLE** Clinical Judgment: Using clinical reasoning, conducts accurate...- 2 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse (RN) & Basic Life Support… more