- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... determinations + Recent work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare, Medicaid, and Managed… more
- Lincoln Financial (Austin, TX)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... Nurse Disability Consultant to our clinical organization. This position will be responsible for reviewing, analyzing, and interpreting...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- CVS Health (Austin, TX)
- …operation. Work schedules may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant you will be responsible for the ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...positions in the job grade within which this position falls. The actual base salary offer will depend… more
- Zurich NA (Austin, TX)
- AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is seeking an AVP, Utilization Review & Pharmacy. This is a fully remote position , ... offering the flexibility of a home-based office. As the AVP of Utilization Review & Pharmacy, you will lead and direct a team of Utilization Review and… more
- Scottish Rite for Children (Dallas, TX)
- …giving children back their childhood! Job Posting Title: Case Manager and Utilization Review Coordinator Location: Dallas - Hospital Additional Posting Details: ... and other areas as assigned + Serve on the Utilization Review Committee for the Scottish +...holds a temporary permit from the Texas Board of Nurse Examiners to practice professional nursing + Minimum 2… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively planning for case management, which includes care ... targeted patient population on a designated unit(s) and/or service lines. This position works with the physicians and interprofessional health care team to… more
- Centene Corporation (Austin, TX)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... START BETWEEN 2PM - 4PM TO WORK 10 HOURS.** ** Position Purpose:** Performs a clinical review and...Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members… more
- Catholic Health Initiatives (Houston, TX)
- …perform other duties as assigned. **Qualifications** **Required:** -Associate's Degree -Registered Nurse (RN) -Two (2) years of experience -Knowledge of case ... interact professionally with case management staff, physicians and payers + If offered the position , you will have 90 days to pass the MCG competency test. However,… more
- Molina Healthcare (Fort Worth, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level… more
- Texas State University (Round Rock, TX)
- …Information Position TitleDirector of Simulation Laboratory / Clinical Nurse Faculty (Open Rank) Job Posting Number2025042NTL Job LocationRound Rock ... College/DivisionCollege of Health Professions Department/SchoolSt. David's School of Nursing Position Description TheSt. David's School of Nursing (http://www.nursing.txstate.edu/) at… more