- Evolent (Austin, TX)
- …Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director, ... discussions with treating providers to ensure appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and … more
- UTMB Health (Galveston, TX)
- …Texas, United States** 1 additional location United States Nursing & Care Management HealthCare System Staffing Requisition # 2504468 Job Summary: Per diem position. ... of information / instructions given. + Aware of community resources for the sexual assault patients. + Functions independently...sexual assault nurse examiners. + Serves as a forensic resource for the hospital staff. + Serves as a… more
- Humana (Austin, TX)
- …of clinical nursing experience + Minimum of 1 year of managed care and case management experience + An active designation as a Certified Care Manager (CCM). ... an individual's comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes. Coordinate medical, behavioral… more
- Highmark Health (Austin, TX)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management , and identification and resolution of quality issues. ... and refer members whose healthcare outcomes might be enhanced by Health Coaching/ case management interventions. + Employ collaborative interventions which focus,… more
- Community Health Systems (Laredo, TX)
- …responsible for coordinating and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role ... care planning. + Maintains accurate and timely documentation of case management activities, including records of referrals,...Bachelor's Degree in Nursing preferred + 2-4 years of clinical nursing experience in a hospital, home health, or… more
- Community Health Systems (Lufkin, TX)
- …responsible for coordinating and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role ... care planning. + Maintains accurate and timely documentation of case management activities, including records of referrals,...Bachelor's Degree in Nursing preferred + 2-4 years of clinical nursing experience in a hospital, home health, or… more
- Datavant (Austin, TX)
- …in DRG downgrade denials and appeal writing for inpatient admission. Experience with clinical criteria resources and payor guidelines. **You will:** + Provide ... denials and appeal writing for inpatient admission. Experience with clinical criteria resources and payor guidelines. *...from these requirements will be reviewed by Datavant Human Resources and determined on a case -by- case… more
- Molina Healthcare (Fort Worth, TX)
- …managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . * Assumes leadership relative to knowledge, ... Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of… more
- HCA Healthcare (Mckinney, TX)
- …work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Medical City McKinney! ... **Description** **Medical City McKinney** **Registered Nurse Supervisor ( Clinical Nurse Coordinator)** **Labor and Delivery** **$10,000 SIGN ON BONUS!**… more
- San Antonio Behavioral Health (San Antonio, TX)
- …+ Attends regular treatment team meetings to provide social work perspectives to total case management of the patient by discussing progress notes charts and ... teams involved. + Provide day to day supervision to clinical team to verify the duties, functions and responsibilities...communicating any state or local agency legal requirement for case management with the interdisciplinary team. +… more