- Molina Healthcare (TX)
- …making appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ... knowledge, knowledge of all relevant and applicable Federal and State regulatory requirements and guidelines, knowledge of Molina policies and procedures, and… more
- Fresenius Medical Center (Tyler, TX)
- **PURPOSE AND SCOPE:** Works with the Facility Manager , facility staff and physician to coordinate the facility operations and patient procedures to ensure provision ... records, patient billing, OSHA and all company, state and federal compliance . **PRINCIPAL DUTIES AND RESPONSIBILITIES:** QUALITY: + Responsible for supporting and… more
- Highmark Health (Austin, TX)
- …for re-assessment. + Ensure all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements and ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...knowledge of disease processes + Working knowledge of pertinent regulatory and compliance guidelines and medical policies… more
- Houston Methodist (Houston, TX)
- …various departments and facilities as it pertains to patient safety, education, nurse triage and clinical quality. The Manager , Clinical Operations position ... across the organization to effectively address patient safety, quality, education and nurse triage needs. The Manager Clinical Operations position works… more
- Houston Methodist (Houston, TX)
- … with ethical and legal business practices and accreditation/ regulatory /government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Performs management responsibilities ... At Houston Methodist, the Manager Clinical Education position is responsible for collaboratively...guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and… more
- Houston Methodist (Sugar Land, TX)
- …compliance with ethical and legal business practices and accreditation/ regulatory / government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Performs management ... At Houston Methodist, the Manager Case Mgmt Social Svcs position is responsible...guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and… 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 ... continued stay and resource use, appropriate level of care and program compliance . Identifies when services no longer meet InterQual/Milliman l criteria, initiates… more
- Houston Methodist (Cypress, TX)
- …Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient ... continued stay and resource use, appropriate level of care and program compliance . Identifies when services no longer meet InterQual/Milliman l criteria, initiates… more
- Houston Methodist (The Woodlands, TX)
- …Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on ... continued stay and resource use, appropriate level of care and program compliance . Identifies when services no longer meet InterQual/Millman l criteria, initiates… more
- Catholic Health Initiatives (College Station, TX)
- …Serves as the subject matter expert for case management Functions and regulatory compliance for the director and department members. **Essential Key ... **Responsibilities** The Manager of Care Coordination assists the Director with..., Care Management postion.** + **Must be a Registered Nurse (RN)** + **Must have have a minimum of… more