- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... acute care indicators and criteria as approved by medical staff, payer guidelines, CMS , and other state agencies. In addition to performing the duties of the… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... care indicators and criteria as approved by medical staff, payer guidelines, CMS , and other state agencies. This position prospectively or concurrently determines… more
- Gentiva (Temple, TX)
- …certification or recertification of a patient's terminal diagnosis, in accordance with CMS requirements. **As a Hospice Nurse Practitioner, You Will:** + ... you may be the perfect fit for our Hospice Nurse Practitioner opportunity. You'll report directly to the Executive...plans to support hospice eligibility + Adhere to the CMS -mandated timeframe for F2F assessments + Ensure all documentation… more
- Kelsey-Seybold Clinic (Houston, TX)
- …has achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including ... **Job Summary:** Certified registered nurse anesthetists (CRNAs) are nationally certified as having the competencies necessary to administer anesthesia and related… more
- Molina Healthcare (San Antonio, TX)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases ... Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and reports… more
- CenterWell (Austin, TX)
- …DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare ... in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- CenterWell (Austin, TX)
- …procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare ... in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- Molina Healthcare (TX)
- …to achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services ( CMS ) and State regulatory requirements are met ... **Job Summary** **_For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of KENTUCKY or have a compact license._** Provides… more
- Fresenius Medical Center (Dallas, TX)
- …material assist- devices for the heavier items. **EDUCATION** + Center for Medicaid/ Medicare Services ( CMS )-approved state and/or national certification or High ... for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training...testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system . + Ensure that all… more
- Fresenius Medical Center (Dallas, TX)
- …"material assist" devices for the heavier items. **EDUCATION** + Center for Medicaid/ Medicare Services ( CMS )-approved state and/or national certification or High ... for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training...testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system . + Ensure that all… more