Current jobs related to RN Mgr-Utilization Review - Austin - Ascension
-
RN-Utilization Review
2 days ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition...
-
RN-Utilization Review
2 days ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition...
-
RN-Utilization Review
23 hours ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition...
-
RN-Utilization Review
2 days ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition...
-
Utilization Review Nurse
21 hours ago
Austin, United States TEKsystems Full timeJob Summary + The Medical Records Utilization Case Manager will support documentation of medical necessity by facilitating medical records (MR) collection and client outreach, by offering expert review and interpretation on a case by case basis, and by maintaining collaborative and productive relationships within the organization relating to Revenue Cycle...
-
Utilization Review Nurse
2 days ago
Austin, United States TEKsystems Full time*Job Summary* * The Medical Records Utilization Case Manager will support documentation of medical necessity by facilitating medical records (MR) collection and client outreach, by offering expert review and interpretation on a case by case basis, and by maintaining collaborative and productive relationships within the organization relating to Revenue Cycle...
-
Austin, Texas, United States Texas Department of Aging & Disability Services Full timeJob Summary: We are seeking a highly skilled Nurse III to join our team as a Managed Care Nurse Analyst - Clinical Review. This senior-level position reports to the Acute Care Utilization Review Unit's (ACUR) Managed Care Clinical Review Manager. As a key member of our team, you will perform complex assessments and analyses of Medicaid MCO utilization...
-
Behavioral Health Analyst
2 months ago
Austin, Texas, United States Texas Department of Aging & Disability Services Full timeJob Summary:This position reports to the Acute Care Utilization Review Manager in the Office of the Medical Director, Medicaid and CHIP Services Department. The Behavioral Health Analyst (Program Specialist VI) performs complex behavioral health managed care utilization review oversight and consultation related to the prior authorization (PA) and...
-
Contract Administration Mgr I
2 months ago
Austin, United States Texas Department of Aging & Disability Services Full timeJob Description: Contract Administration Mgr I This position is eligible for full time telework consistent with DFPS HR Policies. This position performs highly advanced (senior-level) consultative services and technical assistance work related to the solicitation, oversight and monitoring of Single Source Continuum Contractors (SSCC) under the leadership...
-
Contract Administration Mgr II
5 months ago
Austin, United States Texas Department of Aging & Disability Services Full timeJob Description: Contract Administration Mgr. II % REMOTE WORK AVAILABLE WITHIN THE STATE OF TX The contract administration manager II reports to the director of the IT Contract Management section. This position performs highly advanced (senior-level) contract administration and management work for contracts that are large in scope, have a high degree...
-
Utilization Management Specialist
1 week ago
Austin, Texas, United States Integral Care Full timeJob Summary: We are seeking a skilled Utilization Manager to join our team at Integral Care. As a Utilization Manager, you will be responsible for conducting utilization reviews, granting authorizations, and monitoring compliance with various contracts entered into by Integral Care and Tejas Behavioral Health.Key Responsibilities:Conduct utilization reviews...
-
Clinical Review Nurse RN
4 weeks ago
Austin, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Drafts correspondence letters based on review outcomes in...
-
Utilization Management Specialist
2 weeks ago
Austin, Texas, United States Integral Care Full timeJob Summary:The Utilization Manager will be responsible for conducting utilization reviews, granting authorizations, and monitoring compliance with various contracts entered into by Integral Care and Tejas Behavioral Health. This includes contracts with departments of the State of Texas, the City of Austin, Travis County, and managed care health plans. The...
-
Utilization Management Manager
3 days ago
Austin, United States Curative Full timeSUMMARY The Manager of Medical Management and Utilization Management oversees the coordination and execution of daily operations within the Medical Management and UM teams. This role is responsible for driving performance, ensuring compliance with regulatory requirements, optimizing patient care pathways, and maintaining operational efficiencies. The...
-
Clinical Review Specialist
2 weeks ago
Austin, Texas, United States Centene Corporation Full timeJob Summary:Centene Corporation is seeking a skilled Clinical Review Specialist to join our Medical Management/Health Services team. As a key member of our team, you will play a critical role in ensuring the medical appropriateness of care and services related to mental health and substance abuse.Key Responsibilities:Perform clinical reviews and assessments...
-
Document Reviewer
2 weeks ago
Austin, Texas, United States KLDiscovery Full timeJob Title: Document ReviewerKLDiscovery, a leading eDiscovery provider, is seeking attorneys with active licenses in any U.S. jurisdiction to join our team as Document Reviewers.Job Summary:We are looking for highly skilled and detail-oriented attorneys to review documents for complex litigation matters using our electronic review platform. As a Document...
-
Utility Engineer
2 weeks ago
Austin, Texas, United States BGE, Inc. Full timeJob Opportunity: Utility Engineer/CoordinatorBGE, Inc. is seeking a highly skilled Utility Engineer/Coordinator to join our team in the Central Texas Region. As a key member of our Transportation Team, you will be responsible for providing technical support and coordination for utility adjustment efforts to resolve conflicts with utilities impacted by...
-
Application Review Specialist
3 weeks ago
Austin, Texas, United States University of Texas at Austin Full timeJob SummaryWe are seeking a highly organized and detail-oriented Application Review Specialist to join our team at the Department of Computer Science. As a key member of our admissions team, you will be responsible for reviewing and evaluating a high volume of graduate applications.Key ResponsibilitiesReview and evaluate applications for graduate admission,...
-
Document Review Specialist
1 month ago
Austin, Texas, United States KLDiscovery Full timeJob Title: Document ReviewerKLDiscovery, a leading eDiscovery provider, is seeking attorneys with active licenses in any U.S. jurisdiction to join our team as Document Reviewers.Job SummaryWe are looking for highly skilled attorneys to review documents for complex litigation matters using our electronic review platform. As a Document Reviewer, you will code...
-
Clinical Utilization Specialist
4 weeks ago
Austin, Texas, United States Centene Corporation Full timeJob Title: Clinical Utilization SpecialistJoin Centene Corporation, a leading healthcare company, as a Clinical Utilization Specialist. In this role, you will play a critical part in ensuring the quality and appropriateness of mental health and substance abuse services for our 28 million members.Key Responsibilities:Perform clinical reviews and assessments...
RN Mgr-Utilization Review
2 months ago
- Department: Utilization Management
- Schedule: FT - Days
- Location: Remote after training
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics.
ResponsibilitiesManage effective utilization review processes, including management of patient statusing processes and monitoring of medical necessity review functions for assigned sites.
- Collaborate with the director to develop and implement quality review programs and key performance indicators for all utilization review activities.
- Interact with medical, nursing, and executive leadership to facilitate quality based, cost effective patient statusing in the most appropriate setting, in compliance with regulatory and revenue cycle requirements.
- Oversee day-to-day operations of the department and assist with the budgeting process.
- Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation.
- Conduct hiring, training, directing, development and evaluation of staff.
Licensure / Certification / Registration:
- Registered Nurse credentialed from the Texas Board of Nursing obtained prior to hire date or job transfer date required.
Education:
- Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required.
Work Experience:
- Two years of related experience is required.
- Utilization Review management experience required.
Ascension Seton, based in Austin, Texas, has provided thousands of associates and caregivers a rewarding career in healthcare since 1902. Ascension Seton operates more than 100 clinical locations in Central Texas and four teaching hospitals, including Dell Seton Medical Center at The University of Texas and Dell Children's Medical Center. Join us and create a career path you will love.
Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.
Equal Employment Opportunity EmployerAscension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
Pay Non-Discrimination Notice
Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
This Ministry does not participate in E-Verify and therefore cannot employ STEM OPT candidates.