- ChenMed (Houston, TX)
- …+ Participates in surveys, studies and special projects as assigned. + Conducts concurrent medical record review using specific indicators and criteria as ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...resources and mobilizes resources to assist in achieving desired clinical outcomes within specific timeframe. + Conducts review… more
- HCA Healthcare (El Paso, TX)
- …medical services and discharge planning for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes ... knowledge of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical … more
- HCA Healthcare (El Paso, TX)
- …medical services and discharge planning for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes ... knowledge of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical … more
- HCA Healthcare (Tomball, TX)
- …Tomball we support our colleagues in their positions. Join our Team as a Nurse Manager RN Women's Services and access programs to assist with every stage of ... and more affordable to gain certifications and job skills. Apply today for our Nurse Manager RN Women's Services opening and continue to learn! **Job Summary and… more
- Houston Methodist (Katy, TX)
- …medical necessity and level-of-care criteria. + Oversees the denials management clinical team for concurrent , retrospective, and self-denial processes. Recruits, ... completed timely to avoid denials or billing delays. Provides oversight for the concurrent denials and short stay review process in collaboration with physician… more
- Houston Methodist (Katy, TX)
- At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading the daily operations of the Utilization Review ... management practices across the organization. This position ensures timely initial, concurrent , and retrospective reviews for medical necessity, level of care, and… more
- Baylor Scott & White Health (Irving, TX)
- …to find trauma patients. Help collect data for Trauma Registry. + Carry out concurrent reviews of patient charts and stick to departmental deadlines for review ... a relevant field + Must be a licensed Registered Nurse + Basic Life Support (BLS) and Advanced Cardiac...of hire. + RN- Advanced Trauma Care (ATCN), Trauma Nurse Core Course (TNCC): TNCC or ATCN within 180… more
- Molina Healthcare (TX)
- …with Outlook, Excel, Teams, and One Note. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that ... in both NM and TX. Reviews will include, but are not limited to, initial and concurrent stays. Solid experience with Microsoft Office Suite is necessary, especially… 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 ... Education: Holds a current Texas license as a Registered Nurse OR a current Texas Licensed Vocational Nurse...Nurse . B. Training and Experience: Three years of clinical nursing experience in a general medical/surgical setting or… more
- Centene Corporation (Houston, TX)
- …complete for allergies, height, weight, current and past medical history, clinical laboratory results and concurrent medications (including over-the-counter or ... + Assess responses to therapy, patient compliance, and ongoing review of drug regimens; report and manage adverse events...report and manage adverse events + Assist the physician, nurse and patient with clinical and technical… more