- CenterWell (Lubbock, TX)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- HCA Healthcare (Dallas, TX)
- …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay… more
- Molina Healthcare (Fort Worth, TX)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... Experience** 3-5 years clinical practice with managed care, hospital nursing, utilization and/or care management experience. **Preferred License, Certification,… more
- Houston Methodist (The Woodlands, TX)
- …state, local and federal programs + Progressive knowledge of discharge planning, utilization management , case management , performance improvement and managed ... registered nurse (RN) responsible for comprehensively planning for case management , which includes care transitions and discharge planning of a targeted patient… more
- Houston Methodist (Houston, TX)
- …to physicians as appropriate. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Conducts initial management , review and monitoring of all occupational injuries and ... Enterprise Health and Epic.** At Houston Methodist, the Occupational Health Nurse PRN position provides expert, integrated, cost-effective, quality patient care… more
- Sedgwick (Austin, TX)
- …(10) of related experience required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & ... the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability...+ Knowledge of ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical… more
- HCA Healthcare (San Antonio, TX)
- …| Landmark, who is responsible to the Chief Nursing Officer for the management of the areas/units in the department under his/her direction. This includes ... order to facilitate optimum care and health education for patients and appropriate utilization of resources which support daily operation in his/her area. 2. The… more
- Erickson Living (Houston, TX)
- …clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management /Safety ... clinical practice and processes in accordance with the Erickson Senior Living Management Policies and Procedures and nursing standards of practice. + Ownership of… more
- HCA Healthcare (Austin, TX)
- …evaluate, monitor and improve the patient flow program effectiveness as it relates to utilization review , resource management and discharge planning and care ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...team, Nursing, Social Work, PT, OT, Speech and Case Management . * You will serve as the educational leader… more
- System One (Houston, TX)
- …a Category Manager in Houston, TX establish and implement third party Category Management strategies and solutions with the intent to obtain best value in support ... Build out effective Category Strategies by performing analysis on internal utilization , external benchmarking, identify optimized cost models, and develop an… more