- Elevance Health (Houston, TX)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Vascular Surgey is responsible for support and ... with the Director of UM to ensure client satisfaction. + Perform all peer clinical review activities while located in a state or territory of the United States. +… more
- Justice, Bureau of Prisons/Federal Prison System (TX)
- …Level 3 Facility, or Federal Correctional Complexe (FCC). Serves as the Utilization Review Nurse and assists in quality improvement activities through data ... time from designation to arrival; initiation of services and consults; and review of timely care and treatment completes. Responsible for the coordination,… more
- Molina Healthcare (Houston, TX)
- …**Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory ... and reports quality of care issues. + Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review , appropriate… more
- Actalent (San Antonio, TX)
- Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full‑Time About the Role We are ... seeking an experienced Registered Nurse to join our team within a leading Managed...to gather additional information when needed. + Document all review decisions clearly, accurately, and in compliance with regulatory… more
- Elara Caring (Harker Heights, TX)
- …at the Right Time, in the Right Place. **Job Description:** Clinical Team Specialist/Oasis Review Nurse Specialist At Elara Caring, we care where you are and ... Nursing related field required + 2 years home care experience as a registered nurse in a Home Health or Hospice environment + Current, unrestricted RN license valid… more
- HCA Healthcare (Webster, TX)
- …you passionate about delivering patient-centered care?** Submit your application for Registered Nurse Coord Quality position and spend more time at the bedside with ... applications. **What qualifications you will need:** + (RN) Registered Nurse + Associate Degree + 1 year or more...your career! We are interviewing candidates for our Registered Nurse Coord Quality opening. **Apply today and a member… more
- MD Anderson Cancer Center (Houston, TX)
- The primary purpose of the Advanced Practice Nurse position is to provide quality patient care in relation to the patient's prescribed diagnosis, treatment, age ... patients on clinical pathway, writing/calling in prescriptions) Retrieve and review labs, glucose monitoring results, pathology results, radiology reports Facilitate… more
- Veterans Affairs, Veterans Health Administration (Dallas, 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 Registered Nurse may perform a variety of duties in a...as ordered. Provide clear and concise preoperative teaching and review discharge instructions to patients and families with written… more
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