- Centene Corporation (Austin, TX)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... to performance, compliance , quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Austin, TX)
- …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... with diverse cultural dynamics of clinical staff and patients. Registered Nurse ( RN ) required. Licensed...(LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant… more
- CenterWell (Austin, TX)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- Houston Methodist (Houston, TX)
- …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... At Houston Methodist, the Director Case Management & Social Services RN position...in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information… more
- Community Health Systems (Granbury, TX)
- …platforms, healthcare software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... of the Care Management and Resource Management programs. This position ensures compliance with...cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up.… 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...coordinating patient care across the continuum to include case management , social work, utilization review and care… more
- Gentiva (Fort Worth, TX)
- …Executive Director to join our leadership team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care, ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… 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 connectivity ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more