- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the ... with clinical team partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory requirements to make… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the ... the Utilization Review Nurse and Utilization Review Specialist Nurse job...special project activities related but not limited to, throughput, utilization review and utilization management … more
- Texas Health Resources (Arlington, TX)
- …providers and other hospital personnel in understanding payor plans, resolving utilization management issues and assigning appropriate patient classification as ... Registered Nurse (RN) - Case Manager - PRN Work...1. Maintains a current knowledge of regulatory requirements for utilization management including but not limited to… more
- HCA Healthcare (Dallas, TX)
- …Case Management and the Rehab Medical Director. The Clinical Rehabilitation Specialist works closely with hospital case management to ensure a responsive ... **Description** **Medical City Healthcare** Division Inpatient Rehab Specialist Full Time **Introduction** Are you passionate about the patient experience? At HCA… more
- HCA Healthcare (Plano, TX)
- …is recognized. Submit your application for the opportunity below: Assessment Specialist **Benefits** Virtual Patient Logistics Center, offers a total rewards package ... **_Note: Eligibility for benefits may vary by location._** We are seeking an Assessment Specialist for our team to ensure that we continue to provide all patients… more
- Houston Methodist (Sugar Land, TX)
- …**EDUCATION** + Master's degree + Master of Science in Nursing preferred + Clinical Nurse Leader or Clinical Nurse Specialist preferred **WORK EXPERIENCE** + ... and efficiency. The NPM is a clinically active registered nurse who also mentors staff and liaises with internal...Provides guidance to staff in clinical project development and management , using the PDCA process and supporting the Pathway… more
- Molina Healthcare (San Antonio, TX)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Houston Methodist (Houston, TX)
- …in a hospital setting + Two years of experience in Hospital Quality Improvement, Case Management or Utilization Management role preferred + Two years of ... At Houston Methodist, the Quality Outcomes Specialist position is responsible for assessing and facilitating...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure… more
- STG International (Temple, TX)
- …any other protected class. Medical Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse Corps - 66B,66H, 66P Medical Service ... STGi is currently seeking a Pharmacy Nurse -Licensed Vocational Nurse to provide services...care in pharmacy ordering, alternative substitutions and off formulary utilization . 25. Participates as a team member in the… more
- Ascension Health (Austin, TX)
- …of hospital admissions, discharge planning, and length of stay. + Serve as content specialist for staff in the areas of utilization criteria, appeal and review ... **Details** + **Department:** Case Management + **Schedule:** FT - Monday- Friday Days...to hire date or job transfer date. + Registered Nurse obtained prior to hire date or job transfer… more