- CVS Health (Austin, TX)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... compassionate. And we do it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- CVS Health (Austin, TX)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Austin, TX)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Houston Methodist (The Woodlands, TX)
- …eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and managed ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position...nursing experience, which includes two years in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN -… more
- Houston Methodist (Sugar Land, TX)
- …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance… more
- Centene Corporation (San Antonio, TX)
- …review care services related to mental health and substance abuse is preferred. + Utilization Review/ Utilization management with behavioral health cases + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Actalent (San Antonio, TX)
- …to assist each other and complete cases. Qualifications: + 2+ years of utilization management , concurrent review, prior authorization, utilization review, ... case management , and discharge planning is must + ICU/ER experience Preferred + Active RN Compact License is Must If you are Interested , Kindly give a call : ### Pay and Benefits The pay range for this position is $35.00 - $40.00/hr. Eligibility… more
- UTMB Health (Friendswood, TX)
- …area and/or general nursing . + Provides assistance with clinical issues for non- nursing Utilization Review Case Management staff. + Contributes to the ... Medical Staff and Nursing Staff on the Utilization Review/Case Management program and provides specific...school of Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse (RN).… more
- Houston Methodist (Houston, TX)
- …and trends in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information and focuses the ... utilization of resources to avoid denials and resource management as it pertains to delivery of care. **GROWTH/INNOVATION...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more