- CVS Health (Austin, TX)
- …role is 100% remote and the candidate can live in any state. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant...document and communicate all aspects of the utilization /benefit management program. You would be responsible… more
- 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 ... 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
- CVS Health (Austin, TX)
- …all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
- CenterWell (Austin, TX)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… 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
- Cognizant (Austin, TX)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- CVS Health (Austin, TX)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- CVS Health (Austin, TX)
- …Registered Nurse (RN) states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for ... years' experience in critical care + 6+ months case management or utilization management experience...+ Must be able to obtain multi state Registered Nurse (RN) licensures **Preferred Qualifications** + Case Management… more
- CVS Health (Austin, TX)
- …in managed care, clinical, or health care related field. - 1 year of project management experience. - Registered Nurse (RN) license in the state of their ... in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides training and… more
- CVS Health (Austin, TX)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Molina Healthcare (Austin, TX)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical...be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and… 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 ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… 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 ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Austin, TX)
- …Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse Case Manager you can be a part of change. **Benefits** St. David's Medical ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Austin, TX)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization . + You will provide case management services for both ... in their positions. Join our Team as a(an) Registered Nurse Case Manager and access programs to assist with...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Austin, TX)
- …patient throughput while supporting a balance of optimal care and appropriate resource utilization .** + **You will provide case management services for both ... Do you have the career opportunities as a Registered Nurse Case Manager PRN you want in your current...stay, managing the length of stay, ensuring appropriate resource management , and developing a safe appropriate discharge plan in… more
- HCA Healthcare (Austin, TX)
- …passionate about delivering patient-centered care?** Submit your application for Seasonal Registered Nurse Case Manager position and spend more time at the bedside ... work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at St. David's Medical Center!… more