- HCA Healthcare (San Antonio, TX)
- …growth, we encourage you to apply for our Nurse Manager of Progressive Care opening. We promptly review all applications. Highly qualified candidates will be ... Do you have the career opportunities as a(an) Nurse Manager of Progressive Care you want with...care area, and for the acquisition, development, and utilization of resources (human and material) needed to fulfill… more
- Molina Healthcare (San Antonio, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... and appropriate/accurate billing and claims processing. + Identifies and reports quality of care issues. + Assists with Complex Claim review including DRG… more
- HCA Healthcare (Houston, TX)
- …assessment, planning, implementation and overall evaluation of individual patient needs. Care coordination, utilization review and management, as ... physicians and other members of the team on issues related to utilization review including inappropriate admissions and placements. Payer-based requests… more
- Houston Methodist (Nassau Bay, TX)
- …days. Acute Care experience preferred. At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans ... approved utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. Reviews level of care… more
- CenterWell (Austin, TX)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...Review staff relative to data tracking for performance review and outcomes of care analysis to… more
- HCA Healthcare (Dallas, TX)
- …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... for life - and empowers their passion for patient care . Apply today for our RN Case Manager...approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay… more
- HCA Healthcare (San Antonio, TX)
- …Preferred:Bachelor of Science in Nursing + At least one year experience in utilization review , resource management, discharge planning or case management. Prior ... care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of...compelling, we encourage you to apply for our Case Manager RN opening. We promptly review all… more
- Parsons Corporation (San Antonio, TX)
- …on workflow efficiency, and maintaining research documents. Additionally, the Program Manager II will assist with space utilization , financial tracking, ... got what you're looking for. **Job Description:** Parsons is seeking a **Program Manager II** to support Naval Medical Research Unit - San Antonio (NAMRU-SA) and… more
- Prime Healthcare (Harlingen, TX)
- …safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities + Utilization Review : m onitor the use of ... Clinical Case Manager . An RN Case Manager will oversee and coordinate patient care ... transitions. RN Case Managers also conduct discharge planning, utilization review , and helping patients navigate insurance… more
- Houston Methodist (Nassau Bay, TX)
- …approved utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. + Participates in denial ... At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN)...utilization management, case management, performance improvement and managed care reimbursement + Understanding of pre-acute and post-acute venues… more