Utilization Review Jobs in Texas
1 - 15 of 149
Search Results - Utilization Review Jobs in Texas
Humana Inc-San Juan
and Physicians with Inpatient or Utilization Review Experience
Role Overview
• Provide expert clinical review of inpatient medical records and determine medical necessity based on national guidelines, CMS requirements, Humana policies, and clinical standards...
appcast.io -
Curative HR LLC-Austin
to join our growing team. This pivotal role will be responsible for overseeing and performing utilization reviews, prior authorizations, and making crucial medical necessity determinations. The Medical Director will serve as a key clinical expert, ensuring...
trinethire.com -
Humana Inc-San Juan
A major U.S. healthcare provider is seeking a Medical Director to conduct inpatient medical necessity reviews and support high-quality decision-making. This role is ideal for experienced physicians with backgrounds in Hospital Medicine or Critical...
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Revolution Healthcare Services-Brownsville
Requirements:
• Active RN license in Texas
• BLS certification (current)
• InterQual and utilization review experience required
• Discharge planning experience required
• Meditech EMR experience preferred
• Strong team-oriented personality and collaborative...
1 similar job: San Leandro
Humana Inc-Austin
A leading healthcare company seeking a Medical Director to conduct clinical reviews and evaluate health claims. This role requires a physician with significant clinical experience and strong analytical skills. Responsibilities include reviewing...
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GQR Healthcare-Brownsville
Job Description
GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Brownsville, Texas.
Job Description & Requirements
• Specialty: Utilization Review
• Discipline: RN
• Start Date: ASAP...
University Health-Pleasanton (TX)
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current...
Bestica-Brownsville
Interqual and utilization review experience
• Discharge planning experience
Must Have Hospital experience
List typical procedures performed on unit(s):
• Discharge planning
• Care coordination
Candidate should be above 50...
University Health-Boerne
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current...
University Health-Pleasanton (TX)
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current...
University Health-San Antonio
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required. Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse...
University Health-Boerne
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required. Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse...
4 similar jobs: Pleasanton, San Antonio, Hondo, Seguin
Christus Health-Houston
in maintaining/improving the effectiveness of the services provided by the occupational therapy department.
• Participates in medical chart peer review, case record review and utilization review as deemed necessary.
• Assumes responsibility for therapeutic...
University Health-Seguin
is preferred. Three years recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is preferred. Must complete a Clinical Documentation Improvement Course within specified...
4 similar jobs: Boerne, Pleasanton, San Antonio, Hondo
Christus Health-San Antonio
delivery of services through coordinated scheduling.
• Maintains required records/documentations as specified in department policy and procedures manual.
• Participates in medical chart peer review, case records review and utilization review as deemed...
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