- Elevance Health (Grand Prairie, TX)
- ** Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... complete the assessment within 48 hours of receipt and meet the criteria._** The ** Nurse Case Manager II** is responsible for care management within the scope of… more
- Houston Methodist (Sugar Land, TX)
- …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management… more
- Molina Healthcare (Fort Worth, TX)
- …education and experience. * At least 7 years health care management/leadership experience. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), ... Office suite (including Excel), and applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a target ... department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse ( RN ) responsible for comprehensively planning for case management of a ... engagement, ie peer-to-peer accountability. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Houston Methodist (Houston, TX)
- …leading multi-site or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the… more
- CenterWell (Austin, TX)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Baylor Scott & White Health (Dallas, TX)
- …, or related field. 3. 1+ years of experience in a leadership role preferred. 4. Registered Nurse ( RN ) or Licensed Master Social Worker (LMSW) or above 5. ... management, social services, coordination of patient care, patient access, utilization management, and discharge planning. Directs the management and...Worker -- LMSW - Lic Masters Social Worker -- RN - Registered Nurse . As… more
- Houston Methodist (Webster, TX)
- …and timely manner. Takes messages via telephone/email to forward to the provider/ registered nurse . + Contributes towards improvement of department scores for ... to patients visiting the clinic under the direct supervision of a Physician, Registered Nurse , or clinic leadership procedures. In collaboration with the… more
- AdventHealth (Mansfield, TX)
- …performance with oversight to assure capital and fiscal accountability. + Partners with Utilization Management for the Utilization Review Committee as well ... career with AdventHealth, named in 2018 by Beckers Hospital Review as one of the 150 Top Places to...program in Nursing. Currently licensed to practice as a Registered Nurse in the state of Texas,… more
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