- Actalent (Houston, TX)
- Immediate Hiring for " Remote Clinical Review RN" Job Description: + Perform concurrent reviews to assess member's overall health. + Review the type of care ... appropriate setting of care. Qualifications: + 2+ Years of Utilization Management Experience is Mandatory + Active Compact RN...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
- Molina Healthcare (Houston, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... that has a current active unrestricted license This a remote role and can sit anywhere within the United...Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge… more
- Molina Healthcare (Houston, TX)
- …nursing experience in claims auditing, quality assurance, recovery auditing, DRG/clinical validation, utilization review and/or medical claims review , or ... quality audits experience. Work hours are: Monday- Friday 8:00am - 5:00pm Remote position Essential Job Duties * Develops diagnosis-related group (DRG) validation… more
- Molina Healthcare (Houston, TX)
- …DESCRIPTION Fully remote opportunity for a TX licensed RN with Utilization Management experience to join our Prior Authorization reviewing team. Previous UM ... and One Note. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- Molina Healthcare (Houston, TX)
- For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member… more
- Apex Health Solutions (Houston, TX)
- …served. Reports to: Director, Health Services Location: Houston, TX area; will consider remote deployment on a case by case basis Education Education: Registered ... Nurse (RN) LICENSES/CERTIFICATIONS: Registered Nurse (RN) with...travel in the Houston metro area may be required Remote deployment will be considered SKILLS Knowledge of healthcare… more