- CVS Health (Austin, TX)
- …with occasional holiday rotation. **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience + Experience ... it all with heart, each and every day. **Position Summary** Medicare Precertification Nurse Consultant position: _Utilization Management is a 24/7 operation and… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Humana (Austin, TX)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Houston Methodist (The Woodlands, TX)
- …eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and managed ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position...determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the plan… more
- UTMB Health (Webster, TX)
- …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …application. Former EDRP participants ineligible to apply. Responsibilities The Registered Nurse - Mental Health Intensive Case Management (MHICM) position is ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Provides patient-centered, recovery-oriented principles, tele-mental health, community-based… more
- Sharecare (Austin, TX)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- HCA Healthcare (Webster, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse RN Case Management to join our healthcare family. **Benefits** HCA Houston ... - and empowers their passion for patient care. Apply today for our Registered Nurse RN Case Management opportunity. **Job Summary and Qualifications** We are… more
- HCA Healthcare (Houston, TX)
- …and other third-party payers in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved by the ... any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits**...extended stays in accordance with criteria approved by the Utilization Management Committee and Medical Staff with… more
- Houston Methodist (Houston, TX)
- …hospital units through the facilitation and coordination of patient flow and bed utilization . The POE Nurse position collaborates with clinical staff and ... At Houston Methodist, the Point of Entry Nurse (POE) is a licensed registered nurse...interprofessional health care team to ensure resource utilization is appropriate to the patient's clinical needs and… more