- Molina Healthcare (San Antonio, 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** The RN Care Review Clinician provides support for clinical...intensive care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours: Monday… more
- Molina Healthcare (Austin, 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 Clinical Appeals Nurse ( RN ) provides support for internal...to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours:… more
- Health Care Service Corporation (Richardson, TX)
- …health needs within the scope of their benefit plan. **Required Job Qualifications:** + Registered Nurse ( RN ) with current, valid, unrestricted license to ... to obtain multi-state licenses. **Preferred Job Qualifications:** + Familiarity with UM /CM activities and standardized criteria set. + Knowledge of ancillary… more
- Molina Healthcare (Dallas, TX)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... member care. We are seeking a candidate with a RN licensure that has previous UM and Inpatient Hospital experience. Candidates with MCO experience are… more
- 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 ... the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Fort Worth, TX)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Humana (Austin, TX)
- …Standard Time **Required Qualifications** + Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a compact state with no disciplinary ... and independent determination of the appropriate courses of action. As a Utilization Management RN working on the OneHome/Home Solutions UM Team, you will have… more
- Molina Healthcare (San Antonio, TX)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2 years experience,… 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 ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2 years experience,… more
- Health Care Service Corporation (Houston, TX)
- …and facilitates the coordination of care for identified members. **JOB REQUIREMENTS:** ** Registered Nurse ( RN ) with current, valid, unrestricted license ... all other entities involved in managing specialty care. The primary nurse case administrator performs care coordination; identifies alternate treatment programs;… more
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