- Houston Methodist (Houston, TX)
- …of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed...coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC - Clear Lake Center **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2506588 The ... in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively assessing the clinical… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... retrospective review of inpatient admissions and services. This position will...This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process… more
- Houston Methodist (Houston, TX)
- …for providing executive leadership and strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director ... and utilization management initiatives. + Provides strategic vision and execution for case management and utilization review across all hospitals and central… more
- Houston Methodist (Houston, TX)
- …per hospital/ case management and clinical documentation policies policy. + Review issues identified by case management department to ensure appropriate ... documentation to support such determinations. **FINANCE ESSENTIAL FUNCTIONS** + Review medical records identified by case managers,...FUNCTIONS** + Review medical records identified by case managers, or as requested by other members of… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient ... members of the interprofessional health care team to facilitate care for designated case load; monitors the patient's progress, intervening as needed to ensure that… more
- Texas State University (San Marcos, TX)
- …Community Standards with the implementation of the student conduct and care process. The Case Manager will be responsible for the review of conduct cases, ... will bring the HRL conduct process to industry standards. The Case Manager will review , assign, audit, and report key trends or time-sensitive information as… more
- CoreCivic (Eden, TX)
- …and a responsibility to better the public good. CoreCivic is currently seeking a ** Case Processing Specialist** . Come join a team that is dedicated to making an ... impact for the people and communities we serve. The Case Processing Specialist provides case processing and...databases and other governments sources in preparation for ICE review and/or hearing. 4. Assists ICE legal representatives in… more
- HCA Healthcare (San Antonio, TX)
- …will be performed. + Prefer at least one year experience in utilization review , resource management, discharge planning or case management. + RN License ... personal growth, we encourage you to apply for our Case Manager RN PRN opening. We review ...our Case Manager RN PRN opening. We review all applications. Qualified candidates will be contacted for… more
- HCA Healthcare (El Paso, TX)
- …case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical decision ... to make a real impact. As a(an) Registered Nurse Case Manager you can be a part of change....for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes of utilization… more