- Molina Healthcare (TX)
- …making appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ... Utilization Management and Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases in conjunction with… more
- Fresenius Medical Center (Austin, TX)
- …assigned patients in accordance with FMCNA policies,procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... + Provides patientcare under the direct supervision of Hemodialysis Registered Nurse for assigned patient(s)in the acute setting excluding Intensive Care Units… more
- Pilgrim's (Nacogdoches, TX)
- …medical directives within the scope of practice and regulations of the State Nurse Practice Act in the applied state. Adheres to health management policies, ... and physician standing orders according to scope of practice. + Provides compassionate, quality care to employees. + Adheres to all state and federal regulations… more
- Highmark Health (Austin, TX)
- …in achieving their personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a timely manner. **ESSENTIAL ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans to… more
- CenterWell (Brownsville, TX)
- …service **Preferred** **Qualifications:** + Knowledge of HEDIS measures and quality indicators + Experience managing Medicare Advantage panel of patients ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- UT Health San Antonio (San Antonio, TX)
- …Health San Antonio (UTHSA) Stem Cell Transplant and Cellular Therapy (SCTCT) Program. The Quality Manager ensures: Compliance with all aspects of the SCTCT ... Quality Manager , Stem Cell Transplant &...logbooks and other records for completeness, correctness, and external compliance audits. + Performs periodic reviews and audits of… more
- Edwards Lifesciences (Austin, TX)
- …understand nature of complaints and possible health risks; Interprets complaint data for Quality compliance staff, complaint investigators and other Quality ... and be part of our inspiring journey. The Senior Manager , Clinical Product Quality will plan and...plus. + Supervisory or people leadership experience. + Registered nurse with current state license in good standing **What… more
- Houston Methodist (Houston, TX)
- …as it pertains to patient safety, education, nurse triage and clinical quality . The Manager , Clinical Operations position is responsible for maintaining high ... the organization to effectively address patient safety, quality , education and nurse triage needs. The Manager Clinical Operations position works alongside… more
- Houston Methodist (Houston, TX)
- …HM-generated nursing knowledge to both nursing and general healthcare communities. The Manager Clinical Education position serves to implement quality evidence ... , innovative, and timely programs for professional and nonprofessional staff. The Manager Clinical Education position closely monitors quality metrics to adjust… more
- Houston Methodist (Houston, TX)
- …Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient ... + Performs post-discharge review by analyzing the inpatient record to ensure that compliance with quality indicators are met. Intervenes and takes appropriate… more