- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) responsible for promoting ... an expert level at all objectives delineated in the Utilization Review Nurse and ...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- UTMB Health (Galveston, TX)
- Utilization Review Case Mgr - Galv....nursing and current Texas Nursing licensure as a professional registered nurse . Minimum of three years of ... full time wage earning experience as a professional nurse in a health care setting. **JOB DESCRIPTION :**...criteria guidelines. **MAJOR DUTIES / CRITICAL TASKS:** + Implements Utilization review procedures by prospectively, concurrently, and… more
- UTMB Health (Webster, TX)
- …testing is also required. **_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum of three (3) years ... Utilization Review Case Mgr CMC- Clear... Utilization Review Case Mgr CMC- Clear Lake Center **Webster,...transfers and admissions from the prison facility. + Conducts nurse to nurse conference calls for all… more
- Texas Health Resources (Arlington, TX)
- … Management required 3 years previous leadership experience required Licenses and Certifications RN - Registered Nurse Current license to practice ... Director Utilization Management-Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for… more
- Baylor Scott & White Health (Dallas, TX)
- …least (3) three years of professional experience is required. + You must hold a valid Registered Nurse License ( RN ). As a health care system committed to ... vary based upon position type and/or level **Job Summary** + You will review patient cases for medical necessity and establish service suitability. You'll educate… more
- Humana (Austin, TX)
- …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... Previous experience in utilization management and/or utilization review . + Minimum of two (2) years of proven experience in management or leadership role. +… more
- Humana (Austin, TX)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- Texas Health Resources (Arlington, TX)
- Registered Nurse ( RN ) - Case...and continuity of care to prevent readmission. 35% C. Utilization Review : 1. Performs utilization ... Years in an acute care setting, case management or utilization review Req 1 Year of acute...acute case management/discharge planning experience Pref Licenses and Certifications RN - Registered Nurse Upon… more
- Molina Healthcare (San Antonio, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
- Molina Healthcare (Houston, TX)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more