- CVS Health (Austin, TX)
- …it all with heart, each and every day. **Position Summary** This Case Manager - Registered Nurse ( RN ) position is with Aetna's National Medical Excellence ... to apply, however, preference is for candidates in compact Registered Nurse ( RN ) states. This...is a blended role doing both Case Management and Utilization Management. The RN Case Manager is… more
- CVS Health (Austin, TX)
- …care - Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience in ... a hospital setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
- CVS Health (Austin, TX)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- CenterWell (Austin, TX)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...on excellent service to others. **Required Qualifications** + Active RN license + Possession of or ability to obtain… more
- CenterWell (Austin, TX)
- …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
- BAYADA Home Health Care (Austin, TX)
- …with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote , Home Health Coding, Coder, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...Manager with OASIS and Coding certification to work remotely. RN , PT, OT, and SLP's with certifications will be… more
- Prime Therapeutics (Austin, TX)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
- Sharecare (Austin, TX)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Actalent (San Antonio, TX)
- …case management, and discharge planning. + Proficiency with InterQual. + Active Compact RN License. + Utilization Management/Concurrent Review experience. + ... Job Title: Clinical Review NurseJob Description: The Review Nurse will be responsible for reviewing...Skills + Experience in utilization management, concurrent review , prior authorization, utilization review ,… more
- Humana (Austin, TX)
- …and passions. **Use your skills to make an impact** **Required Qualifications** + ** Registered Nurse ( RN )** **with current, unrestricted licensure** + BSN ... involvement in day-to-day UM activities and discussions with UM leaders. 20% 2. Review and monitor Contract Change Orders and evaluate impact on Utilization … more