- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted ... quality, efficient, and cost-effective. + Serves as a preceptor and implements staff education specific to patient populations and unit processes; coaches and… more
- Baylor Scott & White Health (College Station, TX)
- …coordinating patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and ... FACTORS** Knowledge of Care Coordination, discharge planning, case management and utilization review . Knowledge of human behavior and performance; individual… more
- HCA Healthcare (Dallas, TX)
- …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay… more
- Providence (Lubbock, TX)
- …in a medical record. + 2 years - HEDIS, Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within ... Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab...Communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that… more
- Datavant (Austin, TX)
- …healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in...letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +… more
- Houston Methodist (Houston, TX)
- …of timely scheduling, balancing and reporting for departments, partnering with the nurse staffing leadership. This position performs daily staffing to fill nursing ... position acts as a resource to management on scheduling/staffing utilization , education and interpretation of generated staffing/scheduling reports. This position… more
- Fresenius Medical Center (Olmito, TX)
- … staff , if incumbent does not possess a RN license, supervision of nursing staff will be provided by a charge nurse /director of nursing. EDUCATION AND ... authorized to make daily decisions to ensure patient and staff safety, the execution of some tasks may be...and accrediting agency standards where applicable. + Participate in review business and finances of the site, including financial… more
- Fresenius Medical Center (Olmito, TX)
- … staff , if incumbent does not possess a RN license, supervision of nursing staff will be provided by a charge nurse /director of nursing. EDUCATION AND ... authorized to make daily decisions to ensure patient and staff safety, the execution of some tasks may be...and accrediting agency standards where applicable. . Participate in review business and finances of the site, including financial… more
- Baylor Scott & White Health (Dallas, TX)
- …Master's degree preferred. 2. 5+ years of experience in case management, social work, utilization review , or related field. 3. 1+ years of experience in a ... case management, social services, coordination of patient care, patient access, utilization management, and discharge planning. Directs the management and analysis… more
- Houston Methodist (Houston, TX)
- …of Root Cause Analysis (RCA), Failure Modes Effects Analysis (FMEA), or event review as needed. Supports leadership and staff with the development and ... safety and evidence-based practice awareness and practice among clinicians and staff through mentoring and education. Manages project and process improvement… more