- HCA Healthcare (Dallas, TX)
- …1 weekend shift. Shift length may vary and could be from 6-8 hours *_** The Registered Nurse ( RN ) CM is responsible for promoting patient-centered care by ... from any other healthcare provider. We are seeking an RN Case Manager PRN Inpatient Rehab to join our...pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement.… more
- HCA Healthcare (El Paso, TX)
- …with patients and/or families as needed + You will complete accurate and timely utilization review of patient charts to insure appropriate utilization of ... **Description** **Introduction** We are seeking a(an) RN Manager Case Management with Del...information and referrals **What qualifications you will need:** + Registered Nurse + Bachelors Degree or Licensed… more
- Molina Healthcare (San Antonio, TX)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
- Molina Healthcare (Houston, TX)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in the state of Texas. You will be hired to join the inpatient review team doing ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… 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. + Experience in managed care, specialty drugs, care management and utilization review . +… more
- CenterWell (Lubbock, TX)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- AdventHealth (Burleson, TX)
- …equipment used in the healthcare sector. **LICENSURE, REGISTRATION, OR CERTIFICATION REQUIRED:** + Registered Nurse ( RN ) This facility is an equal ... and completes Talent Care accordingly. + Assist with overseeing clinical teams to review utilization and options for product selection. + Assist Director with… more
- Houston Methodist (Sugar Land, TX)
- …+ Occupational health nursing experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... physicians as appropriate. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Conducts initial management , review and monitoring of all occupational...Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- HCA Healthcare (San Antonio, TX)
- …DeterminationsSupervisory experience preferredCertifications, Licenses, and other Special RequirementsCurrent/Active Registered Nurse ( RN ) License within ... performance of assigned home health care team(s)Supervises ongoing case management of all patients ensuring an accurate evaluation and...we encourage you to apply for our Clinical Manager RN opening. We promptly review all applications.… more