- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse ( RN ) who comprehensively conducts point of ... management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Actalent (Houston, TX)
- Job Title: Review Nurse Job Description The ...InterQual. + Active Compact RN License. + Utilization Management /Concurrent Review experience. + ... to ensure the successful completion of cases. Essential Skills + Experience in utilization management , concurrent review , prior authorization, utilization… more
- Molina Healthcare (TX)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
- Molina Healthcare (Fort Worth, TX)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
- UTMB Health (Friendswood, TX)
- …ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical ... manner. **_ESSENTIAL JOB FUNCTIONS_** **:** + Supervises the operational management of the Utilization Review /Case...Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum… more
- CVS Health (Austin, TX)
- …Must be able to obtain multi state Registered Nurse ( RN ) licensures **Preferred Qualifications** + Case Management Certification + Transplant experience ... and every day. **Position Summary** This Case Manager - Registered Nurse ( RN ) position is...blended role doing both Case Management and Utilization Management . The RN Case… more
- Fresenius Medical Center (Houston, TX)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Marble Falls, TX)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- HCA Healthcare (Austin, TX)
- …opportunity. We want your knowledge and expertise! **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is responsible for promoting ... RN license; 6 Months to obtain TX RN license + Certification in Case Management ...encourage you to apply for our Registered Nurse Case Manager PRN opening. We review … more
- HCA Healthcare (Denton, TX)
- …City Denton we support our colleagues in their positions. Join our Team as a Registered Nurse Case Manager and access programs to assist with every stage of ... gain certifications and job skills. Apply today for our Registered Nurse Case Manager opening and continue...Nurse Case Manager opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more