- 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
- Fresenius Medical Center (Waco, 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
- Centene Corporation (Austin, TX)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… 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
- HCA Healthcare (Dallas, TX)
- …in your career path, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a Registered Nurse Case Manager PRN you want...weekends as needed. Hour are typically 8:00am-4:30pm *_ Our RN Case Managers raise the bar by providing clinical… more
- HCA Healthcare (Pasadena, TX)
- …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Case Manager you want with...preferred + Current Texas licensure with State Board of Nurse Examiners as an RN + 1+… more
- HCA Healthcare (El Paso, TX)
- …of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical ... the opportunity to make a real impact. As a(an) Registered Nurse Case Manager you can be...review of patient medical records for purposes of utilization review , compliance with requirements of external… more
- HCA Healthcare (El Paso, TX)
- …of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical ... **Are you passionate about delivering patient-centered care?** Submit your application for Registered Nurse Case Manager PRN position and spend more time… more
- HCA Healthcare (Dallas, TX)
- …provides satisfaction and personal growth, we encourage you to apply for our OR Registered Nurse PRN opening. We review all applications. Qualified ... you have the PRN career opportunities as an OR Registered Nurse PRN you want with your...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more