- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... this position is able to cover a multitude of utilization review functions through point of entry,...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC...**_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum ... observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and...transfers and admissions from the prison facility. + Conducts nurse to nurse conference calls for all… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Utilization Review Registered Nurse ( RN ) provides a clinical review of cases using medical necessity criteria to determine ... or type of service. Alerts and collaborates with appropriate Utilization Review , Physician leadership and/or Provider Team...- 3 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse ( RN ) As a… more
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital ... Utilization Review Program and makes appropriate referrals to designated Physician...A. Education: Holds a current Texas license as a Registered Nurse OR a current Texas Licensed… more
- Health Care Service Corporation (Richardson, TX)
- …appropriate for treatment within the Autism Spectrum Diagnoses (ASD). **JOB REQUIREMENTS:** ** Registered Nurse ( RN ) or Masters-level Behavioral Health ... decision making skills.** **PC and database experience.** **PREFERRED JOB REQUIREMENTS:** ** Utilization review experience.** **3 years clinical experience in… 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
- Molina Healthcare (Dallas, TX)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical...our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The… more
- Molina Healthcare (Austin, TX)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- HCA Healthcare (El Paso, TX)
- …at Las Palmas Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse Case Manager you can be a part of change. **Benefits** Las ... improve positive outcomes for your patients as a (an) Registered Nurse Case Manager. We want your...review of patient medical records for purposes of utilization review , compliance with requirements of external… more
- HCA Healthcare (El Paso, TX)
- …in your career path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a Registered Nurse Case Manager you want in...review of patient medical records for purposes of utilization review , compliance with requirements of external… more