- Molina Healthcare (Fort Worth, TX)
- …using clinical and industry best practices: post-acute care ("SNFist" skilled nursing facility programs), model of care, palliative care, diabetes prevention, home ... health, prior authorizations/referrals. * Provides national best practice strategic direction and oversight for segment population management (including care management, utilization management, auditing and training). * Creates necessary cross-functional… more
- Molina Healthcare (Fort Worth, TX)
- …* Reviews medically appropriate clinical guidelines and other appropriate criteria with chief medical officer on denial decisions. * Resolves escalated ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical...* Prepares and presents cases in conjunction with the chief medical officer for administrative law judge… more
- Texas Health Resources (Arlington, TX)
- …The executive management team for the THSL hospital will consist of the hospital's president, chief nursing officer , entity financial officer , and entity ... activities. THSL will be part of the THR Hospital Channel and the president, chief nursing officer and entity financial officer of THSL will participate… more
- Molina Healthcare (Fort Worth, TX)
- …experience. + Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state ... applicable policies/protocols. **REQUIRED QUALIFICATIONS:** + At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical… more
- Baylor Scott & White Health (Grapevine, TX)
- …Reporting to the SVP, President - BSW Medical Center Grapevine, the VP Chief Operating Officer (COO) - Grapevine is responsible for planning, overseeing, ... bed, Magnet-designated, Level II trauma center. **Essential Functions** - Serves as the chief operations officer (COO) and top operations leader for BSW Medical… more
- HCA Healthcare (Dallas, TX)
- …regular communication with facility Chief Nursing Officers (CNO's) and Chief Medical Officer (CMO's) and engages them as key contacts regarding process ... EBCD, etc. to support staff training and continued education in collaboration with Nursing Education as needed. (crosses over to nursing education). + Actively… more
- HCA Healthcare (Fort Worth, TX)
- …innovation of ideas. **Job Summary and Qualifications** Under the supervision of the Assistant Chief Nursing Officer , the Director of Progressive Care shares ... for the effective and efficient operation of the assigned nursing department(s). Functions will be performed in accordance with...department(s). Functions will be performed in accordance with the nurse practice act in a manner consistent with the… more
- AdventHealth (Mansfield, TX)
- …role you'll contribute:** **GENERAL SUMMARY:** Under minimal supervision and reporting to the Chief Nursing Officer the Director Care Management Women and ... Education* (Certifications and Degrees without out-of-pocket tuition expense) - Nursing Clinical Ladder Program* **Our promise to you:** Joining...Nursing . Currently licensed to practice as a Registered Nurse in the state of Texas, or in a… more
- Molina Healthcare (Fort Worth, TX)
- …and financial results, and keeps executive leadership apprised. * Collaborates with the chief medical officer and medical director team to develop and implement ... * At least 7 years health care management/leadership experience. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse… more
- Molina Healthcare (Fort Worth, TX)
- …Pharmacy and Therapeutics (P&T) and other committees as directed by the chief medical officer . * Evaluates authorization requests in timely support ... of nurse reviewers, reviews cases requiring concurrent review and manages...appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency,… more
- Molina Healthcare (Fort Worth, TX)
- …committees as required such as Credentialing, P&T and others as directed by the Chief Medical Officer . + Evaluates authorization requests in timely support of ... nurse reviewers; reviews cases requiring concurrent review, and manages...appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency,… more
- Molina Healthcare (Fort Worth, TX)
- …Communicates with the Molina Plan Senior Leadership Team, including the Plan President, Chief Medical Officer , national Risk Adjustment teams and strategic teams ... LICENSE, CERTIFICATION, ASSOCIATION:** * Certified Professional in Health Quality (CPHQ) * Nursing License (RN may be preferred for specific roles) * Certified Risk… more