- Molina Healthcare (Austin, TX)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred… 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 ... **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure...experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid,… more
- Centene Corporation (Austin, TX)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers on utilization… more
- CenterWell (Grand Prairie, TX)
- …and providing a positive and welcoming environment for all. **Responsibilities:** The Nurse Practitioner (NP) or Physician Assistant (PA) works in our team-based ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- UTMB Health (Galveston, TX)
- Nurse Practitioner, School of Medicine -Community Based Clinic (Galveston) **Galveston, Texas, United States** 1 additional location Lake Jackson, Texas, United ... **Minimum Qualifications:** + Completion of a graduate level (or higher) nurse practitioner program accredited by the Accreditation Commission for Education in… more
- UTMB Health (Galveston, TX)
- Nurse Practitioner - Radiation Oncology (Oncology experience preferred) **Galveston, Texas, United States** Patient Care UTMB Health Requisition # 2502363 **JOB ... **Minimum Qualifications:** + Completion of a graduate level (or higher) nurse practitioner program accredited by the Accreditation Commission for Education in… more
- Houston Methodist (Houston, 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
- Houston Methodist (Sugar Land, TX)
- …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
- UTMB Health (Galveston, TX)
- Neonatal Nurse Practitioner, Pediatric Neonatology (Casual Appointment) **Galveston, Texas, United States** Patient Care UTMB Health Requisition # 2500903 **Minimum ... Qualifications:** Master's degree in nursing or higher with appropriate nurse practitioner certification for patient care in the area of clinical specialization.… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Clinical Research Nurse (CRN) position is licensed clinician who is responsible for, with minimal supervision, supporting, facilitating and ... and customer service. We are looking for a highly motivated and experienced nurse who is passionate about patient care and research in Neurology. The successful… more