Utilization Review Nurse Jobs in San Antonio, Texas

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121 San Antonio, TX Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 121
Title/Unit: RN Case Manager Shift/Schedule: Days Exciting opportunity to join a strong cosmopolitan growing city in the Texas market! Facility/Description: This opportunity is for a major Specialty Hospital in SE Texas. Responsibilites for this Case Manager will be to work with patient/families identified to have discharge planning, psychosocial, financial or other needs to develop a plan th...
SUMMARY: The Registered Nurse will provide Referral Management (RM) activities include timely processing of Right of First Refusal (ROFR) requests, screening of specialty care referrals, sustaining up-to-date MTF/ Managed Care Support Contact ( MCSC ) Memorandums of Understanding (MOUs), comply with Referral and Authorization Business rules, tracking, accounting, and resulting of referrals, and fu...
Are you ready for an exciting opportunity to enhance your career skill set? Do you want to be a part of one of the country’s fastest growing provider of care facilities? If so, check out this opportunity as a Utilization Review Nurse (RN). This position requires an individual who can work under minimal supervision to review and manage the utilization review activities, pre-certification, concurren...
Description: Are you ready for your next challenge? Discover it here at UnitedHealthcare and help us reinvent the health system. This can be your opportunity to take on a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. You will discuss cases with t...
UnitedHealth Group Inc San Antonio, TX
Position Description WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella. Do you have compassi...
Aetna Inc. San Antonio, TX
Candidate should be highly motivated and have good communication skills. Position is in a Managed care environment which involves working in both telephonic and computer duties. Nursing skills and critical thinking are utilized on a daily basis. Position utilizes clinical skills to coordinate, document and communicate all aspects of teh utilization/benefit management program. Experience in either ...
Molina Healthcare Inc San Antonio, TX
Job Summary Oversees the integrated Care Access and Monitoring team responsible for prior authorizations, inpatient and outpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Monitors information daily as appropriate including member metrics and staff product...
UnitedHealth Group Inc San Antonio, TX
Position Description Be a part of a growing team! This position will have to rotate Saturdays as part of the schedule. The Supervisor Utilization Management is responsible for utilization management which includes Concurrent Review and Prior Authorizations. (Telephonic Inpatient Care Management). Performs reviews of current inpatient services. Determines medical appropriateness of inpatient an...
Molina Healthcare Inc San Antonio, TX
Job Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorization...
Molina Healthcare Inc San Antonio, TX
Job Summary Works with the Utilization Management team and is primarily responsible for prior authorizations. According to guidelines provides inpatient and outpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Assesses services for Molina Members to ensure ...
Description: WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella. WellMed is now part of the O...
Molina Healthcare Inc San Antonio, TX
Job Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorization...
- BLS Healthcare Provider Required - Must maintain current Texas State Registration - 1 year experience required EDUCATION: Graduate of an accredited School Nursing EXPERIENCE: 3 years recent acute care nursing experience. Working knowledge of computers and basic software applications used in job functions such as word processing, graphics, databases, spreadsheets, etc. Utilization review and/...
Description: Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm) Be a part of a growing team! Utilize your case management skills to impro...
EDUCATION: Graduate of an accredited School Nursing EXPERIENCE: 3 years recent acute care nursing experience. Working knowledge of computers and basic software applications used in job functions such as word processing, graphics, databases, spreadsheets, etc. Utilization review and/or case management experience desirable (managed care or hospital setting). LICENSURE/CERTIFICATIONS: Possession of...
EDUCATION: Graduate of an accredited School Nursing EXPERIENCE: 3 years recent acute care nursing experience. Working knowledge of computers and basic software applications used in job functions such as word processing, graphics, databases, spreadsheets, etc. Utilization review and/or case management experience desirable (managed care or hospital setting). LICENSURE/CERTIFICATIONS: Possession of...
EDUCATION: Graduate of an accredited School Nursing EXPERIENCE: 3 years recent acute care nursing experience. Working knowledge of computers and basic software applications used in job functions such as word processing, graphics, databases, spreadsheets, etc. Utilization review and/or case management experience desirable (managed care or hospital setting). LICENSURE/CERTIFICATIONS: Possession of...
Molina Healthcare Inc San Antonio, TX
Job Summary Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for Molina Members that require hospitalization and/or utilization review for other healthcare services. Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff to...
Description: WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella. WellMed is now part of the O...
Molina Healthcare Inc San Antonio, TX
Job Summary Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for Molina Members that require hospitalization and/or utilization review for other healthcare services. Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff to...

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Healthcare Career Tools

Nurse Manager

Salaries

$53,040.00 - $103,400.00
Typical Salary for Nurse Manager in San Antonio
(313 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
41.2%
Master's
30.6%
Associates
22.7%
(216 Respondents)
Source: Monster.com Careerbenchmarking Tool

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