- Community Health Systems (Lufkin, TX)
- …license (Compact or State-Specific Licensure) + **Required (Texas Only):** Active and unencumbered Registered Nurse ( RN ) license + CPHQ or similar ... liaison for all quality-related matters among hospital departments, administration, and medical staff. + Chair and guide the **Performance Improvement Committee** ;… more
- Elara Caring (Dallas, TX)
- …is Required? + Associate degree in Nursing is required + 3 years of experience as a Registered Nurse in home health and/or hospice + Current state license as a ... + Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer...Registered Nurse + Certified Homecare Coding Speicalist… more
- Sedgwick (Austin, TX)
- …accredited college or university preferred. Current Certified Rehabilitation Counselor (CRC) or Registered Nurse ( RN ) license required. Current license, ... clinical evaluations on claims that require additional review based on medical condition, client requirement, and/or complexity. Consults with providers and… more
- Ascension Health (Austin, TX)
- …Improvement Specialists obtained prior to hire date or job transfer date. + Licensed Registered Nurse credentialed from the Texas Board of Nursing obtained prior ... or management experience preferred. **Additional Preferences** + 5 years RN or 3-5 CDI quality audit experience...Central Texas and four teaching hospitals, including Dell Seton Medical Center at The University of Texas and Dell… more
- Humana (Austin, TX)
- …DSNP program **Use your skills to make an impact** **REQUIRED QUALIFICATIONS:** + Registered nurse ( RN ) with unrestricted licensed **OR** independent ... + Knowledge of Medicaid regulatory requirements + Experience with contracting, audit , risk management, or compliance **Additional Information** This position is open… more
- Catholic Health Initiatives (Bryan, TX)
- …mock survey tracers. **Qualifications** Required Education and Experience: + Licensed Registered Nurse , Licensed Clinical Pharmacist, or other Licensed Clinical ... Safety and Performance Improvement activities for assigned hospital and medical staff departments, committees, divisions, service lines and functions. Proactively… more
- Elevance Health (Grand Prairie, TX)
- …background. **Preferred Skills, Capabilities, and Experiences:** + Coding Certificate or Registered Nurse preferred. + Law Enforcement investigation of ... control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare...regarding approved interventions such as recovery of overpayment, pre-payment audit of claims or putting providers on notice. +… more
- Sedgwick (Fort Worth, TX)
- …consult providers and employees; to provide case direction; and to ensure medical information substantiates the need for absence from work. **ESSENTIAL FUNCTIONS and ... clinical review of referred claims; documents decision rationale; and completes medical review of all claims to ensure information substantiates disability. +… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- …billing rules and government regulations. Provides feedback and education related to audit results. * Reviews documentation by physicians and clinical staff as well ... deficiencies or gaps. Identifies trends and provides feedback to medical staff, coders, and management. * Acts as a...the American Health Information Management Association ( AHIMA ), Registered Health Information Technician ( RHIT ) from the… more
- San Antonio Behavioral Health (San Antonio, TX)
- …coordination for referrals/admissions. Will provide assessment of patients, psychiatric and medical status. Responsible for making sure all inquiries, referrals, and ... on proper forms. Responsible to ensure all referral patient medical record information is completed and nursing and clinical.... Assess patient behavior during assessment and notify the RN if PRN medication is needed to address patient… more
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