- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point ... this position is able to cover a multitude of utilization review functions through point of entry,...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Molina Healthcare (Houston, TX)
- …At least 2 years clinical nursing experience, including at least 1 year of utilization review , medical claims review , long-term services and supports (LTSS), ... on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for medical claim and internal… more
- Deloitte (Houston, TX)
- …registered nurse , physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...Nurse (RN) license required + Certified Clinical Documentation Specialist - CCDS (inpatient) certification required. + A minimum… more
- Houston Methodist (Houston, TX)
- …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year ... At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the overall quality...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Quality Outcomes Specialist position is responsible for assessing and facilitating clinical systems and/or processes to ensure that care ... compliance to accreditation standards and regulatory agency requirements. Conducts record review for performance improvement, peer review , patient safety, risk… more
- Molina Healthcare (Houston, TX)
- …managed care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are… more
- ChenMed (Houston, TX)
- …explain nurse practitioner role. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...the clinical operations team and is responsible for providing specialist patient care in nursing homes, skilled nursing facilities… more
- Houston Methodist (Houston, TX)
- …Health Nurse (ABOHN) **OR** + COHN/S - Certified Occupational Health Nurse Specialist (ABOHN) **KNOWLEDGE, SKILLS, AND ABILITIES** + Demonstrates the skills ... At Houston Methodist, the Occupational Health Nurse position provides expert, integrated, cost-effective, quality patient care through the coordination of clinical… more