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...
Desired Experience: Discharge Planning, RN, LVN
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Clinical Documentation Specialist
Utilization review, reimbursement, or coding experience is preferred. Registered Nurse with current Texas licensure....
Desired Experience: RN
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....
Desired Experience: RN

Nurse IV

Health & Human Services Comm - 598 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...
Desired Experience: RN

Utilization Review Nurse (RN) - Case Management - FT

St. Joseph Medical Center - 241 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...
Desired Experience: Discharge Planning, RN

Utilization Review Specialist

Memorial Hermann - 1,544 reviews - Cypress, TX
PRINCIPAL ACCOUNTABILITIES Uses appropriate criteria sets for admission reviews, continuing stay reviews, outlier reviews and clinical appropriateness...
Desired Experience: Discharge Planning, RN

Medical Compliance Auditor - The Health Plan

Texas Children's Hospital - 458 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....
Desired Experience: RN

Health & Social Services Manager - Houston

UnitedHealth Group - 9,937 reviews - Houston, TX
Experience in utilization review, concurrent review and/or risk management. Registered Nurse ( RN ). Ensures standardized execution of workflow processes,...
Desired Experience: Discharge Planning, Case Management, RN

Clinical Documentation Specialist

Houston Methodist - 882 reviews - Houston, TX
Utilization review, reimbursement, or coding experience is preferred. Registered Nurse with current Texas licensure....
Desired Experience: RN

Clinical Appeals Reviewer Senior

WellCare - 808 reviews - Houston, TX 77081 (Bellaire area)
Handles escalated issues from Concurrent Review Nurses. Required - 4 years of experience in a clinical setting with general nursing exposure in UM to include...
Desired Experience: Discharge Planning, RN

Registered Nurse Transplant Coordinator I

Houston Methodist - 882 reviews - Houston, TX
Registered Nurse, Bachelor¿s degree required. Registered nurse with current Texas license. Risk/benefits, including utilization of expanded donors, high-risk...
Desired Experience: CPR Certification, RN, Triage

Field Care Manager - RN

WellCare - 808 reviews - Houston, TX 77081 (Bellaire area)
Licensed Registered Nurse (RN) is required. Promotes effective utilization and monitors health care resources....
Desired Experience: RN

Care Navigator Coordinator

Houston Methodist - 882 reviews - Houston, TX
3.Conducts pre-visit chart review to identify all needed preventive health maintenance, immunizations, and chronic disease interventions....
Utilization Review Specialist
PRINCIPAL ACCOUNTABILITIES Uses appropriate criteria sets for admission reviews, continuing stay reviews, outlier reviews and clinical appropriateness...
Desired Experience: Discharge Planning, RN
LVN - Utilization Review
Kelsey-Seybold Clinic - 237 reviews - Pearland, TX 77584
LVN - Utilization Review. Pearland Administration Review. Licensed Vocational Nurse, CEU requirement. The vocational nurse provides direct nursing care to an...
Desired Experience: LVN