- CVS Health (Austin, TX)
- …Registered Nurse (RN) states. This role is a blended role doing both Case Management and Utilization Management . The RN Case Manager is responsible for ... years' experience in critical care + 6+ months case management or utilization management experience...+ Must be able to obtain multi state Registered Nurse (RN) licensures **Preferred Qualifications** + Case Management… more
- Veterans Affairs, Veterans Health Administration (Waco, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... by the Veteran, rather than narrowly focusing on disease management . The VA Community Living Center (CLC) is a...and illness in a compassionate manner. The CLC Registered Nurse is responsible and accountable for all elements of… more
- HCA Healthcare (El Paso, TX)
- …of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical ... opportunity to make a real impact. As a(an) Registered Nurse Case Manager you can be a part of...review of patient medical records for purposes of utilization review , compliance with requirements of external… more
- Veterans Affairs, Veterans Health Administration (Big Spring, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... period. The duties and responsibilities for the Community Living Center, Registered Nurse include, but are not limited to the following: Provide competent,… more
- Molina Healthcare (Austin, TX)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and...the specific programs supported by the plan such as utilization review , medical claims review ,… more
- CVS Health (Austin, TX)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- HCA Healthcare (El Paso, TX)
- …of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical ... review of patient medical records for purposes of utilization review , compliance with requirements of external...path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all… more
- Houston Methodist (Houston, 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
- HCA Healthcare (El Paso, TX)
- …of case management philosophy/process/role, needs assessment, principles of utilization review /quality assurance, use of InterQual(R) or other clinical ... and retrospective review of patient medical records for purposes of utilization review , compliance with requirements of external review agencies… more
- HCA Healthcare (Houston, TX)
- …national standards for case management scope of services including + Utilization Management supporting medical necessity and denial prevention + Transition ... patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and...growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review … more
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