- Molina Healthcare (Fort Worth, TX)
- …and monitoring clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and ... and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management … more
- Catholic Health Initiatives (College Station, TX)
- …order to be considered for the Manager, Care Management postion.** + **Must be a Registered Nurse ( RN )** + **Must have have a minimum of Five (5) years ... Management a. Serves as a clinical resource for utilization management , compliance for the...and 3 years leadership experience Required License and Certification: Registered Nurse ( RN ) Required Minimum… more
- Evolent (Austin, TX)
- …and as an RN - **Required** + Minimum of 5 years in Utilization Management , health care Appeals, compliance and/or grievances/complaints in a quality ... appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- CVS Health (Austin, TX)
- …Must be able to obtain multi state Registered Nurse ( RN ) licensures **Preferred Qualifications** + Case Management Certification + Transplant experience ... and every day. **Position Summary** This Case Manager - Registered Nurse ( RN ) position is...blended role doing both Case Management and Utilization Management . The RN Case… more
- Fresenius Medical Center (Round Rock, TX)
- …appropriate training according to FMS policy, including training to ensure ongoing compliance with all FMS risk management initiatives. + Provides opportunities ... vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure… more
- Fresenius Medical Center (Del Rio, TX)
- …+ Assists with implementing appropriate training according to policy; ensure ongoing compliance with all risk management initiatives. + Responsible for ... staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and… more
- Fresenius Medical Center (Farmers Branch, TX)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... federal compliance . **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Responsible for supporting...with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are… more
- Fresenius Medical Center (Marble Falls, TX)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... PHYSICIANS: + Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical Staff By-Laws. + Responsible for… more
- HCA Healthcare (Lewisville, TX)
- …nurses at Medical City Lewisville have the opportunity to make a real impact. As a Registered Nurse Case Manager PRN you can be a part of change. **Benefits** ... and improve positive outcomes for your patients as a Registered Nurse Case Manager PRN. We want...during weekdays for the first few weeks *_ Our RN Case Managers raise the bar by providing clinical… more
- HCA Healthcare (Weatherford, TX)
- …at Medical City Weatherford have the opportunity to make a real impact. As a Registered Nurse Case Manager you can be a part of change. **Benefits** Medical ... and improve positive outcomes for your patients as a Registered Nurse Case Manager. We want your...8:00am-4:30pm Monday - Friday with some weekends *_ Our RN Case Managers raise the bar by providing clinical… more
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