- Centene Corporation (Austin, TX)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... states: California, Mississippi, Texas, or Oregon.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… more
- Molina Healthcare (Houston, TX)
- …**Preferred Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Texas A&M University System (College Station, TX)
- …of insurance guidelines and prior authorization processes. + Ability to review and interpret clinical documentation to determine what is required for ... Job Title Registered Nurse II - Prior Authorization &...are denied. + Collaborate with providers to gather necessary clinical documentation and address denials or escalations. + Tracks… more
- HCA Healthcare (Live Oak, TX)
- …important to you, we encourage you to apply for our ICU Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as an ICU Clinical Nurse Coordinator and access programs to...encompassed by job duties; and must check with supervisors ( prior to job performance) if there is a question… more
- Elevance Health (Grand Prairie, TX)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Advanced Practice Nurse (APN) III Psychiatric Mental Health Nurse ...the Veterans Affairs (VA) mission. The PMHNP provides advanced clinical practice, consultation, and management. The PMHNP practices to… more
- Veterans Affairs, Veterans Health Administration (Big Spring, TX)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... Summary This position reports to the Community Living Center (CLC) Nurse Manager and is under Extended Care Nursing Service at the West Texas VA Health Care System.… more
- Veterans Affairs, Veterans Health Administration (Duncanville, TX)
- …a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... Summary Functions as a clinical expert and is responsible and accountable for...throughout the continuum of care. Responsibilities The Community Care Nurse Manager (NM) is the designated first-line supervisory authority… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- …Management criteria to perform basis review while developing technical and clinical competencies. The Nurse is a novice with limited experience with ... a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program.… more
- Veterans Affairs, Veterans Health Administration (Lubbock, TX)
- …You will provide primary care to an assigned patient panel as delineated in the clinical privilege list for a primary care nurse practitioner. This will include, ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
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