- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the… more
- TEKsystems (Dallas, TX)
- …8 AM-5 PM CST Quality Assurance Responsibilities: + Perform quality assurance review of peer review reports, correspondences, addendums, or supplemental reviews. ... and specifications are followed and all questions addressed. + Verify each review is supported by current clinical citations and references from reputable medical… more
- Molina Healthcare (Houston, TX)
- …**Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory ... and reports quality of care issues. + Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review , appropriate… more
- Actalent (San Antonio, TX)
- Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full‑Time About the Role We are ... seeking an experienced Registered Nurse to join our team within a leading Managed...to gather additional information when needed. + Document all review decisions clearly, accurately, and in compliance with regulatory… more
- HCA Healthcare (Webster, TX)
- …you passionate about delivering patient-centered care?** Submit your application for Registered Nurse Coord Quality position and spend more time at the bedside with ... applications. **What qualifications you will need:** + (RN) Registered Nurse + Associate Degree + 1 year or more...your career! We are interviewing candidates for our Registered Nurse Coord Quality opening. **Apply today and a member… more
- Veterans Affairs, Veterans Health Administration (Fort Worth, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Dedicated Charge Nurse , Patient Aligned Care Team (PACT) duties include, but...VHA Education Loan Repayment Services program office after complete review of the EDRP application. Former EDRP participants ineligible… more
- HCA Healthcare (Austin, TX)
- …Center we support our colleagues in their positions. Join our Team as a(an) Registered Nurse Trauma Care Unit and access programs to assist with every stage of your ... certifications and job skills. Apply today for our Registered Nurse Trauma Care Unit opening and continue to learn!...maintain IV fluids and IV medications . You will review all new physician orders, ensure that orders are… more
- HCA Healthcare (Round Rock, TX)
- …learning is important to you, we encourage you to apply for our Registered Nurse ICU opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as a(an) Registered Nurse ICU and access programs to assist with every...maintain IV fluids and IV medications * You will review all new physician orders, ensure that orders are… more
- HCA Healthcare (Austin, TX)
- …learning is important to you, we encourage you to apply for our Registered Nurse ICU opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as a(an) Registered Nurse ICU and access programs to assist with every...maintain IV fluids and IV medications * You will review all new physician orders, ensure that orders are… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Respect, and Excellence. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for… more