- Texas Health Resources (Dallas, TX)
- …experience required. * One year of hospital case management experience is preferred. * RN - Registered Nurse Upon Hire Req or LMSW - Licensed Master ... all available resources. Assesses patient information utilizing psychological and medical knowledge. Utilization Review and Management * Performs effective … more
- Molina Healthcare (TX)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Houston, TX)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS)… more
- Houston Methodist (The Woodlands, TX)
- …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse - Texas State Licensure ... At Houston Methodist, the Director Case Management & Social Services RN position...excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of… more
- CenterWell (San Angelo, 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
- Children's Home Healthcare (Amarillo, TX)
- …authorizations for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional ... * RN LICENSE REQUIRED, DO NOT APPLY IF YOU...CPR + At least 2 years experience as a Registered Nurse + At least 1 year...skills and willing to travel to patient homes + Utilization Management Experience + Reliable transportation for… 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
- Erickson Living (Dallas, TX)
- …of medical practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that ... by Erickson Senior Living Join our team as a RN Case Manager (also known as Care Coordinator, Erickson...+ Researches and selects care options as appropriate. The nurse care coordinator may utilize a range of alternative,… more
- HCA Healthcare (Irving, TX)
- …degree in Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse ( RN ) licensure, Licensed Clinical Social Worker ... interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational...we encourage you to apply for our Director Case Management opening. We promptly review all applications.… more
- Centene Corporation (Austin, TX)
- …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more