- CenterWell (Lubbock, TX)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more
- Fresenius Medical Center (Olmito, TX)
- …any governmental or regulatory body having jurisdiction in the premises. Assists the Medical Staff to ensure that medical practices and procedures meets ... Safety Code + Plan personnel, equipment, and medications needed for medical emergencies; incorporate into Emergency Preparedness Plan; ensure maintenance of… more
- HCA Healthcare (Dallas, TX)
- …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... being on the front line, empathetic for patients. At Medical City Dallas our nurses set us apart from...approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay… more
- Houston Methodist (Houston, TX)
- …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... most clinically appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs… more
- Houston Methodist (The Woodlands, TX)
- …quality, patient satisfaction and safety measures. **FINANCE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and ... At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively planning for case management, which includes care… more
- Houston Methodist (Houston, TX)
- …leadership team. + Functions as resource to department staff in communicating medical information required by external review entities, managed care contractors, ... At Houston Methodist, the Case Manager (CM) Advanced position is a registered nurse (RN) responsible for promoting the achievement of optimal clinical and resource… more
- HCA Healthcare (Dallas, TX)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… 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 ... status of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of… more
- Molina Healthcare (Fort Worth, TX)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... timely completion. + Actively participates in the Department auditing program to review and communicate findings with staff and identify opportunities for improved… more
- Medical Center Hospital (Odessa, TX)
- …of the Trauma patient is required. One year experience in performance improvement, utilization review and teaching is preferred. C. Job Knowledge Comprehensive ... Graduate of an accredited school of nursing, current License as a Registered Nurse in the State of Texas. BSN preferred. Certification in CEN/CCRN; ACLS; PALS;… more