- 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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- CVS Health (Austin, TX)
- …heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% work at home and the candidate can live in ... any state. **Work At Home Requirements:** + Candidate will work from ...sit for long periods of time. + As a Utilization Management Nurse Consultant, you… 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
- 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 ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible… 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)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… more
- Veterans Affairs, Veterans Health Administration (Waco, TX)
- …and well-being, as defined by the Veteran, rather than narrowly focusing on disease management . The VA Community Living Center (CLC) is a nursing home setting, ... human responses to health and illness in a compassionate manner. The CLC Registered Nurse is responsible and accountable for all elements of the nursing process when… more
- HCA Healthcare (Houston, TX)
- …national standards for case management scope of services including + Utilization Management supporting medical necessity and denial prevention + Transition ... Healthcare Northwest have the opportunity to make a real impact. As a(an) Registered Nurse Case Manager PRN you can be a part of change. **Benefits** HCA Houston… more
- HCA Healthcare (Kingwood, TX)
- …us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** HCA Houston Healthcare ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- HCA Healthcare (Houston, TX)
- …national standards for case management scope of services including + Utilization Management supporting medical necessity and denial prevention + Transition ... integrity. We care like family! Jump-start your career as a(an) Registered Nurse Case Manager today with HCA Houston Healthcare Northwest. **Benefits** HCA Houston… more
- HCA Healthcare (Brownsville, TX)
- …Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse RN Case Manager you can be a part of change. **Benefits** Valley Regional ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- HCA Healthcare (El Paso, TX)
- …role or related health care experience. Working knowledge of case management philosophy/process/role, needs assessment, principles of utilization review/quality ... Palmas 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** Las Palmas Medical… more
- ChenMed (Houston, TX)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent adheres to strict departmental goals/objectives, standards ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...care in nursing homes, skilled nursing facilities (SNF) and home settings, or supporting a Cardiologist practice. The responsibilities… more
- Houston Methodist (Houston, TX)
- …state, local and federal programs + Progressive knowledge of discharge planning, utilization management , case management , performance improvement and managed ... registered nurse (RN) responsible for comprehensively planning for case management , which includes care transitions and discharge planning of a targeted patient… 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 ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- HCA Healthcare (Conroe, TX)
- …is recognized. Submit your application for the opportunity below:Registered Nurse Case ManagerHCA Houston Healthcare Conroe **Benefits** HCA Houston Healthcare ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… 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
- 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 ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- HCA Healthcare (Dallas, TX)
- …set us apart from any other healthcare provider. We are seeking a Registered Nurse Case Manager to join our healthcare family. **Benefits** Medical City Heart & ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more