Top 57008 Insurance company nurse Jobs

Utilization Management Nurse
TEXAS INDEPENDENCE HEALTH PLAN INC —Austin, TX
- Weekends as needed
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Registered Nurse (RN)
Jacob Healthcare Center —San Diego, CA
- Weekends as needed
- Nursing
- RN License
- English
- Health insurance
- Dental insurance
NEW INCREASED RATES!—Starting at $2669.80 for 36 hrs a week and up! - Psych RN in Pueblo, CO
Amergis Healthcare Staffing —Pueblo, CO
- $1,918 a week
- 18 years or older
- CPR Certification
- Psychiatry
- Profit sharing
- Commuter assistance
Quick Apply
9d
Registered Nurse RN Transfer Coordinator Full Time Days
The George Washington University Hospital —Washington, DC
- Full-time
- Nursing
- Computer literacy
- Writing skills
- Health insurance
- Dental insurance
Utilization Review Nurse
St. Augustine Health Ministries —Cleveland, OH
- $31 - $47 an hour
- 8 hour shift
- Background check
- RN License
- Computer literacy
- Free parking
- Health savings account
Quick Apply
Registered Nurse - Freelance AI Trainer Project
Meridial —Austin, TX
- $6 - $65 an hour
- Remote
- Nursing
- Medication administration
- RN License
- Health insurance
Nurse Itemized Bill Reviewer (IBR Analyst)
Machinify —California City, CA
- $80,000 - $90,000 a year
- Remote
- Microsoft Excel
- LVN
- RN License
- Health savings account
- Health insurance
Registered Nurse
Regency Care Center —Norwalk, IA
- CPR Certification
- Nursing
- Skilled nursing facility
- Disability insurance
- Health insurance
Quick Apply
NURSE/RN
NFI North, Inc. —Bradford, NH
- On call
- Nursing
- Psychiatry
- RN License
- Paid holidays
- Disability insurance
Quick Apply
Registered Nurse, RN, 5,000 Sign On Bonus
Gentiva —Lancaster, PA
- Full-time
- CPR Certification
- Nursing
- RN License
Quick Apply
Registered Nurse Case Manager SIGN ON BONUS
Advantage Plus Homecare —Jasper, TX
- $36 - $42 an hour
- Email
- In person
- RN License
- Mid-level
- Home Health
- Paid holidays
- Health insurance
Quick Apply
Registered Nurse (RN)
Maple Springs —Palmer, AK
- From $40 an hour
- 12 hour shift
- Skilled nursing facility
- RN License
- Nursing home
- Health insurance
- Dental insurance
Quick Apply
RN - Registered Nurse Coordinator - Transplant
Geisinger —Danville, PA
- Full-time
- Nursing
- Vital signs
- Hospital
- Wellness program
- Health savings account
Registered Nurse (RN - Homecare and Hospice) - Sign-On Bonus for Full-Time*!
St. Joseph Villa Homecare and Hospice —Omaha, NE
- Full-time
- Skilled nursing facility
- RN License
- Nursing home
- 401(k) matching
Quick Apply
Clinical Nurse Coordinator - FT - Day - Acute Care
Transylvania Regional Hospital —Brevard, NC
- Full-time
- Mid-level
- Critical & Intensive Care
- Medical-Surgical
- Employee stock purchase plan
- Disability insurance
Quick Apply
Clinical Nurse Coordinator OR
Mission Hospital —Asheville, NC
- Full-time
- Surgery
- Mid-level
- Children
- Employee stock purchase plan
- Disability insurance
Quick Apply
Registered Nurse - Case Worker
Encircle —Winchester, VA
- From $75,000 a year
- Full-time
- Clean driving record
- RN License
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Administrative Registered Nurse
Divine House, Inc. —Willmar, MN
- $38 - $40 an hour
- Full-time
- CPR Certification
- Nursing
- Clean driving record
- Health insurance
- Dental insurance
Quick Apply
6d
Night Shift - RN Registered Nurse
NHC HealthCare Lewisburg —Lewisburg, TN
- $36 - $41 an hour
- Night shift
- RN License
- Hospital
- Patient care
- Paid holidays
- Disability insurance
Quick Apply
5d
Hospice Registered Nurse (RN)
Pathways Hospice & Palliative Care —Chesterfield, MO
- Full-time
- Skilled nursing facility
- RN License
- Nursing home
- Paid holidays
- Health insurance
Quick Apply

I want to receive the latest job alert for insurance company nurse

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

insurance company nurse jobs near

Utilization Management Nurse

TEXAS INDEPENDENCE HEALTH PLAN INC -
Austin, TX

Quick Apply

Job Details

Full-time

Qualifications

Nursing
Microsoft Excel
Microsoft Outlook
Medicare
LVN
RN License
Managed care organization experience
Word embeddings
Medicaid health insurance
Utilization management
Resource utilization in healthcare
Acute care experience

Full Job Description

Primary Responsibilities

The Utilization Management Nurse will determine the medical appropriateness of inpatient and outpatient services by evaluating medical guidelines, benefit determination and compliance with state mandated regulations.

Essential Functions

Perform concurrent, retroactive and pre-service authorization reviews for inpatient and outpatient services.
Follow and maintain compliance with CMS requirements, may include after-hours, holiday and weekend coverage.
Collaborate with staff, physicians, care/service coordinators, and medical directors to coordinate and provide the level of care necessary to meet member’s health need.

Educational/Training Requirements

Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience.
Payor Utilization Management: 3 years recommended experience
Proficiency with Microsoft Office applications, specifically Word, Excel, and Outlook
Proficiency using Milliman Care Guidelines (MCG) and/ or InterQual criteria.

Licensing Requirements

Current unencumbered LVN or RN license in Texas or compact license.

Experience Requirements

2+ years Utilization management experience with a health insurance company (managed care/payer experience required).
UM for Medicare Advantage, Managed Medicaid, Dual SNP Lines of Business, on the payer side.
5+ years of acute clinical experience.
The ability to effect change, perform critical analyses, promote positive outcomes, and facilitate empowerment for members/families.

Location

This position is remote, but requires the employee to live within our service area which can include any of the following areas within Texas: Rio Grande Valley, DFW, greater Austin, greater Houston, greater San Antonio, Coastal Bend, or Laredo.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Location: Hybrid remote in Austin, TX 78789

Quick Apply

Refine Your Search

insurance company nurse jobs

Utilization Management Nurse

Registered Nurse (RN)

NEW INCREASED RATES!—Starting at $2669.80 for 36 hrs a week and up! - Psych RN in Pueblo, CO

Registered Nurse RN Transfer Coordinator Full Time Days

Utilization Review Nurse

Registered Nurse - Freelance AI Trainer Project

Nurse Itemized Bill Reviewer (IBR Analyst)

Registered Nurse

NURSE/RN

Registered Nurse, RN, 5,000 Sign On Bonus

Registered Nurse Case Manager SIGN ON BONUS

Registered Nurse (RN)

RN - Registered Nurse Coordinator - Transplant

Registered Nurse (RN - Homecare and Hospice) - Sign-On Bonus for Full-Time*!

Clinical Nurse Coordinator - FT - Day - Acute Care

Clinical Nurse Coordinator OR

Registered Nurse - Case Worker

Administrative Registered Nurse

Night Shift - RN Registered Nurse

Hospice Registered Nurse (RN)

I want to receive the latest job alert for insurance company nurse

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected