- 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 ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- 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 ... this position is able to cover a multitude of utilization review functions through point of entry,...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/233537/registered-nurse-case- manager utilization ... CENTER IS LOOKING FOR A PRN REGISTERED NURSE CASE MANAGER TO WORK WEEKENDS. WE OFFER: + Competitive PRN...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Deloitte (Dallas, TX)
- …+ Experience as clinical registered nurse, physician, physician assistant, case manager , clinical documentation specialist, utilization review , informatics ... RN, Quality, DRG Validation and health IT preferred + Knowledge of Medicare reimbursement system and coding structures preferred + In-depth knowledge and experience in medical terminology, medical coding, and ICD-10-CM/PCS, IPPS payment system is a plus' +… more
- Houston Methodist (Houston, TX)
- …projects to bigger picture system ideas.** At Houston Methodist, the Senior Manager Operations position is responsible for the strategic and ongoing development, ... effective interpersonal skills and oral/written communication skills. The Senior Manager Operations position is responsible for the efficient and effective… more
- Parsons Corporation (San Antonio, TX)
- …on workflow efficiency, and maintaining research documents. Additionally, the Program Manager II will assist with space utilization , financial tracking, ... talent and redefine what's possible. **Job Description:** Parsons is seeking a **Program Manager II** to support Naval Medical Research Unit - San Antonio (NAMRU-SA)… 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 ... for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use,… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted ... engagement, ie peer-to-peer accountability. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource… more
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