- CVS Health (Austin, TX)
- …6:00 pm EST or 9:30am to 6:00pm EST with occasional weekend/holiday/evening rotation.** ** Utilization Management is a 24/7 operation and work schedules will ... with heart, each and every day. Medicare Clinical Predetermination Nurse **Must be willing and able to work Monday...or 9:30am to 6:00pm eastern with occasional weekend/holiday/evening rotation. Utilization Management is a 24/7 operation and… more
- CenterWell (Austin, TX)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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
- CVS Health (Austin, TX)
- …all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit ... solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other… 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
- Actalent (Dallas, TX)
- …Utilization Management )100% Remote Job Description The role of the Utilization Management Nurse involves performing concurrent reviews, determining ... and appropriate setting of care. Essential Skills + 2+ years of utilization management and utilization review expertise. + Experience in concurrent review… more
- CenterWell (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
- Houston Methodist (Houston, TX)
- …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance… more
- Elevance Health (Grand Prairie, TX)
- ** Utilization Management Representative I** **Location:** This role enables associates to work virtually full-time, with the exception of required in person ... **Hours:** Monday - Friday, 8am - 5pm PST The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more