Top 12 Utilization management nurse Jobs in Sherman Tx

Regional MDS
Tikva Healthcare —Texas
- $80,000 - $100,000 a year
- Full-time
- Anatomy knowledge
- RN License
- HIPAA
- Travel reimbursement
- Health insurance
Quick Apply
10d
Staff Nurse Outpatient Clinic CCS
Carrus Health —Sherman, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
LEAD CASE MGR (RN)
Texoma Medical Center —Denison, TX
- Full-time
- Acute care
- Nursing
- Surgery
FT Registered Nurse CBH
Carrus Health —Sherman, TX
- Full-time
- Nursing
- Microsoft Excel
- LVN
Quick Apply
FT Registered Nurse Rehab
Carrus Health —Sherman, TX
- Full-time
- Nursing
- Patient monitoring
- RN License
Quick Apply
FT Registered Nurse MS
Carrus Health —Sherman, TX
- Full-time
- Nursing
- Patient monitoring
- RN License
Quick Apply

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Regional BOM
Tikva Healthcare —Texas
Collaborate with clinical staff, finance teams, and third-party payers to resolve billing discrepancies and optimize cash flow.
$50,000 - $60,000 a year
Quick Apply
10d
Regional MDS
Tikva Healthcare —Texas
This vital role ensures compliance with federal and state regulations, enhances clinical documentation accuracy, and promotes optimal patient care outcomes.
$80,000 - $100,000 a year
Quick Apply
10d

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RN, LSW, LISW, Care Manager - Columbus
Careforth —Columbus, OH
Ability and flexibility to travel (usually by car) within assigned geographic area; valid driver’s license and car insurance required.
$62,657 - $84,173 a year
Infection Prevention Staff Development IPSD
Majestic Care of Whitehall —Whitehall, OH
Current LPN or RN license by State Board of Nursing in state employed; license must be active, valid, and in good standing.
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11d

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utilization management nurse jobs near sherman tx

Regional MDS

Tikva Healthcare
Texas

Quick Apply

Job Details

Full-time
$80,000 - $100,000 a year
10 days ago

Benefits

Travel reimbursement
Health insurance
Dental insurance
Paid time off
Vision insurance
Life insurance

Qualifications

Anatomy knowledge
Medicare
Nursing home experience
RN License
Clinical documentation
Health information management

Full Job Description

Job Summary

We are seeking a dynamic and detail-oriented Regional MDS (Minimum Data Set) Director (RN) to lead and coordinate comprehensive resident assessments across multiple healthcare facilities within our region. This vital role ensures compliance with federal and state regulations, enhances clinical documentation accuracy, and promotes optimal patient care outcomes. The Regional MDS Coordinator will serve as a key liaison among interdisciplinary teams, managed care organizations, and regulatory bodies, driving quality improvement initiatives and ensuring adherence to Medicare, Medicaid, and long-term care standards. This position offers an exciting opportunity to influence clinical practices on a regional scale while supporting the delivery of exceptional patient-centered care.

Duties

Oversee the development, review, and completion of MDS assessments in accordance with CMS (Centers for Medicare and Medicaid Services) regulations, ensuring timely submission and accuracy.
Collaborate with nursing staff, physicians, social workers, and other healthcare professionals to gather comprehensive clinical documentation aligned with clinical documentation standards.
Conduct thorough documentation reviews to identify gaps in medical records, optimize coding accuracy including ), ICD-10 (International Classification of Diseases),, and ensure compliance with HIPAA and health regulation policies.
Lead utilization management efforts by analyzing patient data to support appropriate level of care decisions, discharge planning, and case management strategies for long-term care, hospice, acute care, and inpatient settings.
Provide training and ongoing education to staff on EMR/EHR systems such as PCC, and iQies.
CMS regulations through regular audits of medical records and documentation review processes.

Skills

Extensive knowledge of PCC and other electronic health record platforms.
Must be a Registered Nurse (RN)
Extensive knowledge of PDPM reimbursement and State Medicaid reimbursement.
Strong understanding of managed care processes including Medicare/Medicaid regulations and long-term care policies.
Experience in Long Term Care Nursing.
Proficiency in medical documentation review techniques.
Familiarity with healthcare regulation policies such as HIPAA, CMS guidelines, Quality Measure standards, state healthcare regulations, and long-term care regulations.
Excellent case management skills with the ability to coordinate discharge planning across diverse settings like hospice or emergency medicine environments.
Effective communication skills for collaborating with multidisciplinary teams while providing training on clinical documentation improvement initiatives.

Join us in shaping the future of patient-centered healthcare by ensuring precise documentation that supports quality outcomes! This paid position offers an engaging environment where your expertise directly impacts the delivery of compassionate care across multiple facilities within our region.

Pay: $80,000.00 - $100,000.00 per year

Benefits:

Dental insurance
Health insurance
Life insurance
Paid time off
Travel reimbursement
Vision insurance

Work Location: On the road

Quick Apply

Refine Your Search

utilization management nurse jobs in sherman tx

Regional MDS

Staff Nurse Outpatient Clinic CCS

LEAD CASE MGR (RN)

FT Registered Nurse CBH

FT Registered Nurse Rehab

FT Registered Nurse MS

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