- Humana (Austin, TX)
- …help us put health first** Full-Time, Remote Telephonic opportunity 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...Time **Required Qualifications** + Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in… more
- CVS Health (Austin, TX)
- …work S/S/M/T 10 hour shifts (AFTER training M-F for about 4 - 5 months).** ** Utilization Management is a 24/7 operation and work schedules will include holidays ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...or eastern time zone (AFTER 4-5 months of training). Utilization Management is a 24/7 operation and… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Texas Health Resources (Arlington, TX)
- Director Utilization Management -Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... leader for system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes and delegates activities… more
- Cognizant (Austin, TX)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Elevance Health (Grand Prairie, TX)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Humana (Austin, TX)
- …put health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and… more
- UTMB Health (Galveston, TX)
- …consumption, and achieve positive patient outcomes. + Educates the Medical Staff and Nursing Staff on Utilization Management and provides specific ... Utilization Mgt (10hr shifts) **Galveston, Texas, United States** Nursing & Care Management UTMB Health Requisition...school of professional nursing and current Texas Nursing licensure as a professional registered nurse .… more
- Houston Methodist (Houston, TX)
- …and trends in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information and focuses the ... utilization of resources to avoid denials and resource management as it pertains to delivery of care. **GROWTH/INNOVATION...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Houston Methodist (Sugar Land, TX)
- …years clinical nursing /patient care experience which includes three years in utilization review, case management or equivalent revenue cycle clinical role + ... partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more