Utilization Review Nurse jobs in Houston, TX

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Utilization Review Nurse
IntegraNet Health - Houston, TX
The Utilization Review Nurse works independently to plan, implement, and/or coordinate quality patient care and cost effective utilization of healthcare...
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Staff Nurse III (First Assistant Certification) Pediatric Su...
Certification as an operating room nurse. Concerning home care, potential problems, emotional concerns or utilization....
Case Manager
Completes Utilization Management and Quality Screening for assigned patients. The role integrates and coordinates resource utilization management, care...

Clinical Documentation Specialist

Houston Methodist - 907 reviews - Houston, TX
Coding and utilization review experience preferred. Registered Nurse - Current Texas or compact licensure;...

Utilization Review Nurse (RN) - Case Management - FT

St. Joseph Medical Center - 248 reviews - Houston, TX 77002 (Downtown area)
The Utilization Review Nurse covers all of the nursing units throughout the hospital so as to ensure that all patients are seen when providing relief for the RN...

Nurse IV

Health & Human Services Comm - 616 reviews - Houston, TX
$4,714 - $7,533 a month
The Nurse Reviewer plans and conducts reviews and investigations, prepares reports and makes appropriate notification for the Office of Inspector Utilization...

Administrative Assistant

Harris County - 124 reviews - Houston, TX
$32,614 - $35,298 a year
Reviews and verifies information and submits to Medicaid billing provider. Compiles monthly reports related to program utilization and other statistical needs...

RN Nurse Case Manager - North/Northwest Houston

Cigna - 2,769 reviews - Houston, TX
Knowledge of utilization review requirements and procedures. Current Licensure as a registered nurse, in the state of....

Medical Compliance Auditor - The Health Plan

Texas Children's Hospital - 480 reviews - Houston, TX
At least two years of managed care expertise, and/or utilization review experience. Perform Clinical and Coding Review on Medical Claim Appeals....

Outpatient Care Nurse

Universal American - 98 reviews - Houston, TX 77081 (Bellaire area)
Reviews service requests submitted by physicians to include review of evidence/clinical documentation and its medical necessity....

Research Nurse - Infectious Diseases

MD Anderson Cancer Center - 465 reviews - Houston, TX
Prior Research Nurse experience. Effectively share expertise with other nurses. Coordinate clinic visits, chart review, personal interviews, and diagnostic...

Care Navigator Coordinator

Houston Methodist - 907 reviews - Houston, TX
3.Conducts pre-visit chart review to identify all needed preventive health maintenance, immunizations, and chronic disease interventions....

Case Manager

Memorial Hermann - 1,600 reviews - Houston, TX
Completes Utilization Management and Quality Screening for assigned patients. The role integrates and coordinates resource utilization management, care...
Case Manager - Health Plan
Act as resource person for Utilization Review staff. Current, unrestricted Texas licensure to practice as a Registered Nurse required and CCM certification...
Medical Compliance Auditor - The Health Plan
At least two years of managed care expertise, and/or utilization review experience. Perform Clinical and Coding Review on Medical Claim Appeals....