- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... medical record review for medical necessity and level of ...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of ...this position is able to cover a multitude of utilization review functions through point of entry,… more
- CenterWell (Austin, TX)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... of our caring community and help us put health first** The Utilization Management (UM) Administrative Coordinator 2 is responsible for providing high-quality support… more
- CenterWell (Austin, TX)
- …and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional… more
- CenterWell (Austin, TX)
- …and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience +… more
- Elevance Health (Grand Prairie, TX)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ " The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- BAYADA Home Health Care (Austin, TX)
- …around this requirement.** BAYADA Home Health Care is hiring a full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager ... Minimum of 1 year experience with coding and OASIS review . + Knowledge of OASIS, Home Care ...should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance,… more
- BAYADA Home Health Care (Austin, TX)
- …Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, ... your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding,… more
- HCA Healthcare (San Antonio, TX)
- …growth, we encourage you to apply for our Nurse Manager of Progressive Care opening. We promptly review all applications. Highly qualified candidates will be ... Do you have the career opportunities as a(an) Nurse Manager of Progressive Care you want with...care area, and for the acquisition, development, and utilization of resources (human and material) needed to fulfill… more
- HCA Healthcare (Houston, TX)
- …for patient care . Apply today for our Registered Nurse Case Manager opportunity. **Job Summary and Qualifications** Under the direction of the Case Management ... ancillary staff on individual nursing units to promote ongoing review of patient care activities related to... activities related to provision of services, patterns of care , and utilization of resources. + Assists… more