- Molina Healthcare (San Antonio, 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 ... (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
- CenterWell (Austin, TX)
- …community and help us put health first** 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 of a team that focuses on excellent… 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 (Fort Worth, TX)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Houston, TX)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Houston Methodist (Houston, TX)
- …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for… more
- Baylor Scott & White Health (Temple, TX)
- …minimum qualification - EXPERIENCE - 5 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse ( RN ) As a health care system committed ... **JOB SUMMARY** Manager Comphrensive Care Management RN manages the activities and staff responsible for...across the continuum to include case management, social work, utilization review and care coordination to achieve… more
- Houston Methodist (Houston, TX)
- …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- Baylor Scott & White Health (College Station, TX)
- …MAJOR - Nursing - EXPERIENCE - 3 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse ( RN ) As a health care system committed to ... **JOB SUMMARY** Supervisor Comphrensive Care Management RN supervises the daily activities and staff responsible...across the continuum to include case management, social work, utilization review and care coordination to achieve… more
- Houston Methodist (Houston, TX)
- …transplant acute care and/or ICU experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact ... At Houston Methodist, the Pre-Transplant Coordinator position a registered nurse , responsible for participating in department initiatives, facilitating, and… more