Top 874 Quality improvement nurse Jobs in Houston Tx

RN Case Manager Acute Care
River Oaks Hospital and Clinics —Houston, TX
- $70,000 - $80,000 a year
- Full-time
- Background check
- Spanish
- Nursing
- Disability insurance
- Health insurance
Quick Apply
MDS Nurse (RN/LVN)
West Janisch Health Care Center —Houston, TX
- Full-time
- Background check
- CPR Certification
- Nursing
- Free parking
- Health savings account
Quick Apply
Program Director (PT, OT, or SLP)
Lifepoint Rehabilitation —Houston, TX
- Full-time
- Experience working with individuals with disabilities
- Hospital
- Computer literacy
Quick Apply
REGISTERED NURSE w/CONSCIOUS SEDATION - RIVER OAKS HOSPITAL & CLINICS
Advanced Diagnostics Healthcare System —Houston, TX
- $50 - $54 an hour
- 8 hour shift
- Background check
- Nursing
- Surgery
- Health insurance
- Dental insurance
Quick Apply
Nurse Manager
Memorial Surgical Center —Houston, TX
- $42 - $50 an hour
- Full-time
- Background check
- Nursing
- RN License
- Paid holidays
- Health insurance
Quick Apply
Registered Nurse (RN) Healthcare Facility Surveyor - Remote
Essential Healthcare Solutions LLC —Texas
- $82,000 - $95,000 a year
- Remote
- Nursing
- Skilled nursing facility
- Surgery
- Travel reimbursement
- Paid holidays
Quick Apply
Quality Nurse - Oncology
Onco360 —Houston, TX
- From $80,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Bachelor of Science
- Paid holidays
- Disability insurance
Quick Apply
4d
RN Health Coach (Harris County, Texas)
Genuine Health Group LLC —Harris County, TX
- $84,000 a year
- Full-time
- Background check
- Spanish
- Nursing
- Paid holidays
- Health insurance
Quick Apply
Staff Nurse II - Practice Plan-(Family Medicine)
UTHealth Houston —Houston, TX
- Nursing
- RN License
- BLS Certification
- Health insurance
- Employee discount
3d
Staff Registered Nurse - Surgery Oncology Clinic - Medical Center
Houston Methodist Specialty Physician Group —Houston, TX
- Full-time
- Nursing
- Microsoft Outlook
- Medication administration
9d
Registered Nurse (RN) – Ambulatory Surgery Center (ASC)
Gulf Coast Pain and Spine —Houston, TX
- $75,000 - $85,000 a year
- Full-time
- Surgery
- RN License
- BLS Certification
- Paid holidays
- Health insurance
Quick Apply
3d
STAR+PLUS Appeals Nurse RN
Harris Health —Houston, TX
- $80,000 - $100,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
13d
Clinical Documentation Improvement- MD or APP
Suvida Healthcare —Houston, TX
- Full-time
- Medicine
- Mid-level
- Travel
- Paid parental leave
- Paid holidays
Quick Apply
UTILIZATION REVIEW NURSE - RN
Nexus Health Systems Ltd —Houston, TX
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Nurse Educator, RN
Eagle's Trace by Erickson Senior Living —Houston, TX
- From $96,000 a year
- 18 years or older
- Nursing
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
Point of Entry Nurse
Houston Methodist Hospital —Houston, TX
- Full-time
- Acute care
- Nursing
- Microsoft Excel
Shift Lead
XpresCheck —Houston, TX
- $28 an hour
- 8 hour shift
- Hospitality
- HIPAA
- Laboratory experience
- 401(k) matching
Quick Apply
Registered Nurse, Quality
Townsen Memorial Hospital —Houston, TX
- Full-time
- Background check
- Nursing
- Surgery
- AD&D insurance
- Disability insurance
Quick Apply
Associate Director - Clinical Documentation Improvement (CDI)/HIM
MD Anderson —Houston, TX
- $111,000 - $167,000 a year
- Full-time
- Hybrid work
- RN License
- Master's degree
- Bachelor's degree
- Health insurance
- Dental insurance
FT Registered Nurse Navigator (Houston Area)
Joycare Therapy LLC —Houston, TX
- $95,000 - $100,000 a year
- Full-time
- Hybrid work
- Spanish
- Nursing
- RN License

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quality improvement nurse jobs near houston tx

RN Case Manager Acute Care

River Oaks Hospital and Clinics
Houston, TX

Quick Apply

Job Details

Full-time
$70,000 - $80,000 a year

Benefits

Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Life insurance

Qualifications

Spanish
RN License
Intake
Patient assessment
BLS Certification
Microsoft Office
Managing patients as a nurse case manager
Driver's License
Medical records
Case management
Patient care
Discharge planning

Full Job Description

SUMMARY

This position works closely with the interdisciplinary team to facilitate and maintain compassionate, safe and efficient quality care and achieve desired treatment outcomes. This position works closely with the team to ensure effective discharge planning and continuity of care; and communicates clinical information to payers to ensure reimbursement.

Job Duties and Responsibilities
1. Collaborates with the physician and team to facilitate care, monitor the patient’s progress, intervening as needed to ensure high quality, efficient, and cost-effective services to the patient that are timely.

2. Educates staff and serves as a resource for meeting needs of the patient and facility.

3. Performs review for medical necessity of admission, continued stay and resource use, appropriate level of care and program compliance.

3.1 Identifies when services no longer meet criteria, initiates discussion with physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from physician advisor when needed, and informs management of possible need for issuing Medicare Hospital Initiated Notice of Non-coverage.

3.2 Applies approved utilization criteria to monitor appropriateness of admissions, level of care, resource utilization, and continued stay.

3.3 Reviews level of care denials to identify trends and collaborates with team to recommend opportunities for process improvement.

4. Plans for routine / difficult discharge and anticipates / prevents and manages emergent situations. Specific focus is given to discharge plan and elimination of barriers.

5. Performs post-discharge review by analyzing the medical record to ensure that compliance with quality indicators is met. Communicates reports to appropriate leader regarding regulatory concerns.

6. Monitors length of stay (LOS) on an ongoing basis. Proactively takes action to expedite care / facilitate discharge.

6.1 Manages all patients in observation status, daily, informing physicians of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital.

6.2 Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and state / federal agencies.

6.3 Responds to requests for information, monitors covered days, initiates review to assure that all days are covered and reimbursable.

7. Supports and follows the mission, vision, values and policies of the hospital and communicates with the appropriate leadership and staff.

Qualifications (Education, Experience and Certifications)

Education: RN graduate from an accredited nursing program. Master’s Degree preferred.

Certification, Licensure: Current license as a registered nurse in the state of Texas; current American Heart Association BLS certification.

Experience, Training, Knowledge: Three (3) years hospital clinical experience; two (2) years case manager experience.

KNOWLEDGE, Skills And Abilities
Strong assessment, organizational and problem solving skills

Knowledge of Medicare, Medicaid and managed care requirements.

Comprehensive knowledge of community resources, healthcare financial and payer requirements and eligibility requirements for county, state and federal programs.

Adept at computer operating skills, including Microsoft Office.

Job Type: Full-time

Pay: $70,000.00 - $80,000.00 per year

Benefits:

401(k)
Dental insurance
Disability insurance
Employee assistance program
Health insurance
Life insurance
Paid time off
Vision insurance

Medical Specialty:

Primary Care

Language:

Spanish (Required)

Ability to Commute:

Houston, TX 77027 (Required)

Ability to Relocate:

Houston, TX 77027: Relocate before starting work (Preferred)

Work Location: In person

Quick Apply

Refine Your Search

quality improvement nurse jobs in houston tx

RN Case Manager Acute Care

MDS Nurse (RN/LVN)

Program Director (PT, OT, or SLP)

REGISTERED NURSE w/CONSCIOUS SEDATION - RIVER OAKS HOSPITAL & CLINICS

Nurse Manager

Registered Nurse (RN) Healthcare Facility Surveyor - Remote

Quality Nurse - Oncology

RN Health Coach (Harris County, Texas)

Staff Nurse II - Practice Plan-(Family Medicine)

Staff Registered Nurse - Surgery Oncology Clinic - Medical Center

Registered Nurse (RN) – Ambulatory Surgery Center (ASC)

STAR+PLUS Appeals Nurse RN

Clinical Documentation Improvement- MD or APP

UTILIZATION REVIEW NURSE - RN

Nurse Educator, RN

Point of Entry Nurse

Shift Lead

Registered Nurse, Quality

Associate Director - Clinical Documentation Improvement (CDI)/HIM

FT Registered Nurse Navigator (Houston Area)

I want to receive the latest job alert for quality improvement nurse in houston tx

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