Utilization Review Nurse Jobs in San Antonio, Texas
8 San Antonio, TX Utilization Review Nurse jobs found on Monster.Jobs 1 to 8 of 8
Description: Position Summary: *Option to work from home after 90 days of Proven Performance* the Medical Review Nurse conducts independent review, research and analysis of requests for retrospective medical necessity determination with concentration on prudent standards of best practice and clinical decision sets. Adherence to Health Plan benefits and Medicare Guidelines is required. Outstanding...
Description: Be a part of our growing team! No nights or on-call! This is an office based position and all candidates must be able to work on Saturday as a regular schedule or rotation. Shifts vary starting at 8:00 and 10:00 am and ending between 5:00 and 7:00 pm. The Utilization Management Nurse is responsible for reviewing proposed hospitalization, home care, and inpatient/outpatient treatment p...
Description: Be a part of our growing team! Improve the quality of care for our patients. WellMed is looking for RN Transition Care Managers (Case Managers) - UM Nurses for our growing team in San Antonio. The RNs are responsible for utilization management and inpatient care management coordination and will perform reviews of current inpatient services, and determine medical appropriateness of inp...
Bachelor's Degree POSITION SUMMARY/RESPONSIBILITIES Plans, coordinates, designs, implement and evaluates the Quality Assurance program for assigned area. Ensures the departments compliance with University Health System policies and. procedures, Joint Commission standards, and all other applicable state and federal regulations and guidelines. EDUCATION/EXPERIENCE Graduation from an accredited colle...
POSITION SUMMARY/RESPONSIBIILITIES Plans, coordinates and implements the Quality Management and Improvement Program and the Utilization Management Program Plan for Community First with focus on pended claims and claim appeals, and quality assurance activities to support health services, such as training and auditing. Reviews, evaluates and processes all Health Services Management (HSM) pended clai...
Expectation for All Employees Support the organization’s mission, vision and values by exhibiting the following behaviors: model integrity, embrace innovation, celebrate success, strive for excellence, focus on those we serve and foster trust. Job Purpose Perform medical record review as required by contracts. Make sound, independent decisions based on submitted evidence in accordance with statute...
Expectation for All Employees Support the organization’s mission, vision and values by exhibiting the following behaviors: model integrity, embrace innovation, celebrate success, strive for excellence, focus on those we serve and foster trust. Job Purpose Support the Medicare Appeals team by serving as supervisor of review coordinators including acting as subject matter expert for appeal reviews....
Director of Quality and Clinical Effectiveness San Antonio, TX This position is with one of the largest systems in the area. They were recognized in a national quality study as one of the top five percent of hospitals in the nation for a number of different units in their facilities. It is the only hospital system in the area to achieve healthgrade's highest designation! They also received five st...
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2 questions about the hospital?
What are the main job titles of people who work at the hospital? What is it like to work at a hospital? Thank you in advance.
Is anyone here a Nurse? Can you explain to me what your job is like, and whether you think it may su...
I like the idea of helping sick people, that seems like it would be very rewarding. I also like the idea of being on £20,000 per year! I have seen pictures on the internet of people with severed ar...
Help for a nurse that is just starting in nursing management on a Alzheimer's unit.?
I've been a nurse for about 5 years. I've done a variety of jobs including; hospital, utilization review, disease management, travel and agency. I have recently been hired by a small LTC facility a...
What are some nursing jobs besides being a bedside nurse?
I am currently a 2nd semester nursing student and have been undergoing several different clinical rotation experiences. I've recently got to work on an oncology floor and now I am doing med-surg. I ...
Healthcare Career Tools
$53,600.00 - $103,400.00
Typical Salary for Nurse Manager in San Antonio
Source: Monster.com Careerbenchmarking Tool
Education / Training
Source: Monster.com Careerbenchmarking Tool
Promotes and restores patients' health by developing day-to-day management and long-term planning of the patient care area; directing and developing staff; providing physical and psychological support for patients, friends, and families.
Rate of Growth
Size of Industry in 2006:
Source: Bureau of Labor Statistics, May 2006
Maintains nursing operations by initiating, coordinating, and enforcing program, operational, and personnel policies and procedures.
Identifies patient service requirements by establishing personal rapport with potential and actual patients and other persons in a position to understand service requirements.
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