- Veterans Affairs, Veterans Health Administration (Big Spring, TX)
- …during the open period. The duties and responsibilities for the Community Living Center, Registered Nurse include, but are not limited to the following: Provide ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- Molina Healthcare (San Antonio, TX)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- ChenMed (Houston, TX)
- …rapidly expanding and we need great people to join our team. The Registered Nurse , Telehealth is responsible for providing telephonic emergency triage ... issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. The incumbent in this role… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …Employees using this announcement must update their applications every 90 days. As the Registered Nurse , you will use professional standards of care and practice ... research activities to improve care. Identify and assess resource utilization and safety issues, taking appropriate action. Work Schedule:...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Molina Healthcare (Houston, TX)
- …Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in the state...care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Houston Methodist (Houston, TX)
- …+ Two years of leadership experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... Two years of experience in Hospital Quality Improvement, Case Management or Utilization Management role...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- Elevance Health (Grand Prairie, TX)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Location:** Virtual: This role enables... license in applicable state(s) required. + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
- Molina Healthcare (Austin, TX)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... management initiatives and analytical studies aimed at optimizing utilization of medical resources and maximizing operational efficiencies. + Engages with… more
- Elevance Health (TX)
- …patients with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + ... **Transitions of Care - RN , 100% Virtual, CareBridge** Location: This role enables...for participating in delivery of patient education and disease management interventions and for performing health coaching for members,… more
- Actalent (Houston, TX)
- …management , and discharge planning. + Proficiency with InterQual. + Active Compact RN License. + Utilization Management /Concurrent Review experience. + ... Job Title: Review Nurse Job Description The Review Nurse ...successful completion of cases. Essential Skills + Experience in utilization management , concurrent review, prior authorization, … more