- Conifer Revenue Cycle Solutions (Frisco, TX)
- …supervisory experience CERTIFICATES, LICENSES, REGISTRATIONS Preferred: Active state Registered Nurse license or Certified Coding Specialist credential ... and CDI Lead No. Indirect Reports (incl. titles) CDI Lead and CDI Specialist KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be… more
- 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
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician...Education: Holds a current Texas license as a Registered Nurse OR a current Texas Licensed Vocational Nurse… more
- Molina Healthcare (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
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- HCA Healthcare (Dallas, TX)
- …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... commitments to referral sources. Develops a call-plan to prioritize utilization of time. + Assists in developing the annual...we encourage you to apply for our Clinical Rehab Specialist opening. We promptly review all applications.… more
- Datavant (Austin, TX)
- …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in...letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +… more
- Deloitte (Dallas, 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
- HCA Healthcare (San Antonio, TX)
- …disciplinary team maintaining effective communication with Emergency Department staff, Utilization Review Staff, Admissions Staff, Attending Psychiatrists, ... organization that invests in you as an Assessment Referral Specialist ? At Methodist Healthcare, you come first. HCA Healthcare...and maintains ONE of the following:** A. Licensed Registered Nurse to practice professional nursing in the state of… 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 (Austin, 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
- HCA Healthcare (San Antonio, TX)
- …to clinicians regarding deficiencies or OASIS corrections (with feedback from Quality Review Specialist ) to ensure the medical records reflect compliance with ... medical necessity, homebound status, visit utilization , and documentation of individualized patient assessment and transition (discharge) planning.Reviews agency… more
