- Actalent (Dallas, TX)
- Clinical Review Nurse (Utilization Management)100% Remote Job Description The role of the Utilization Management Nurse involves performing concurrent ... utilization management and utilization review expertise. + Experience in concurrent review and prior authorization. + Knowledge in managed care and patient… more
- Houston Methodist (Houston, TX)
- … functions through point of entry, observation progression of care management, concurrent review and denials reviews. Additionally, the URSN will prospectively ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is... (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… 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 ... gain certifications and job skills. Apply today for our Nurse Manager RN Women's Services opening and continue to...relationships across the hospital** + **Ability to manage multiple concurrent projects and maintain a work pace appropriate to… more
- HCA Healthcare (Houston, TX)
- …Registered Nurse Clinical Reviewer opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. ... in their positions. Join our Team as a(an) Registered Nurse Clinical Reviewer and access programs to assist with...resource to Hospital and Medical Staff + Responsible for concurrent audits of patient charts. Inputs data for tracking,… more
- AdventHealth (Burleson, TX)
- …winning facility and departments including Great Place to Work by Beckers Hospital Review and Gallup. + Work with the latest technology and top experts including ... trauma protocols and guidelines are being followed by observation and chart review . Reviews trauma team activations and assesses for appropriateness based on… more
- UTMB Health (Friendswood, TX)
- …a mechanism for the review of quality of care issues arising during concurrent review , and identifies areas of potential medical liability. + Educates the ... cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical knowledge, expertise, approved… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... charts and records to evaluate care concurrent with patients' treatment. Reviews treatment plans and status...insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use… more
- Texas Health Resources (Arlington, TX)
- …and all identified potentially compensable events (consumers and product). Concurrent review of medical records against pre-established criteria/quality ... Degree or related Field preferred + RN - Registered Nurse RN - Registered Nurse Upon Hire...to address identified risk. + Ability to acquire and review multiple data sources and provide detailed analysis to… more
- Medical Center Hospital (Odessa, TX)
- …interprofessional care plan, and communication of individual patient needs. Conducts initial, concurrent , and retrospective review functions in support of the ... Position Summary: The Case Manager Nurse is responsible for leading the interprofessional team...LVN or RN with the Texas State Board of Nurse is required. Bachelor's Degree in Nursing preferred. Training… more