- Actalent (Houston, TX)
- "Urgent Hiring for " Utilization Review RN " Job Description: + Perform concurrent reviews to assess member's overall health. + Review the type of care ... in utilization management and utilization review /managed care/hospital setting as an RN is...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
- Cognizant (Austin, TX)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral,… more
- Humana (Austin, TX)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- CVS Health (Austin, TX)
- …in clinical setting with diverse cultural dynamics of clinical staff and patients. Registered Nurse ( RN ) required. Licensed Clinical Social Worker (LCSW) ... Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and...in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience… more
- Molina Healthcare (Dallas, TX)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support... licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review… more
- CVS Health (Austin, TX)
- …with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any ... care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care +… 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
- 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 ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Home Care Providers of Texas (San Antonio, TX)
- The Regional Manager (RM) is a registered nurse who provides day-to-day support to direct care team members (RNs, LPN/LVNs, CNAs, Therapists, etc.) including ... Antonio, Austin, & New Braunfels, TX This is a Remote Position, living in Region is preferred. Occasional travel...for meetings. Requirements . Current State License as a Registered Nurse . 2 years of home… more
- Health Care Service Corporation (Richardson, TX)
- …office visits to acute in-patient to out-patient office visits. **JOB REQUIREMENTS:** * Registered Nurse ( RN ) or Masters-level Behavioral Health Professional ... skills. *PC and database experience. **PREFERRED JOB REQUIREMENTS:** * Utilization review experience. *MUST be licensed to...of years) at the independent practice level *If a Registered Nurse ( RN ): must have… more