- Evolent (Austin, TX)
- …Join a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. We ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse , you will routinely interact with...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Evolent (Austin, TX)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse , you will routinely interact with...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Evolent (Austin, TX)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks ... cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Elevance Health (Grand Prairie, TX)
- **Case Reviewer (NP/PA)** **Carelon Medical Benefit Management** **Orthopedic Surgery** **Virtual:** This role enables associates to work virtually full-time, with ... unless an accommodation is granted as required by law._ The **Case Reviewer ** is responsible for conducting pre-authorization, out of network and appropriateness of… 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 concurrent medical record review for medical necessity and level of care using...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… 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 and level of care using...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- HCA Healthcare (Houston, TX)
- …you, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. Our team will promptly review your application. Highly qualified ... our colleagues in their positions. Join our Team as a(an) Registered Nurse Clinical Reviewer and access programs to assist with every stage of your career.… more
- Molina Healthcare (Houston, TX)
- …meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical ... experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. Experience… more
- Veterans Affairs, Veterans Health Administration (Big Spring, TX)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... This position reports to the Community Living Center (CLC) Nurse Manager and is under Extended Care Nursing Service...completed work may require routine or detailed higher level review depending upon the complexity of the duties involved.… more
- Veterans Affairs, Veterans Health Administration (Austin, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... evidence-based-practice culture. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential… more