- Excellent verbal, written, and interpersonal communication skills required as demonstrated by past job experience.
- Strong analytical, data management and computer skills.
- Able to work with people of all social, economic, and cultural backgrounds.
- Flexible, open-minded and adaptable to change.
- Understanding of pre-acute and post-acute venues of care and community resources.
- Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
- Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients/families.
- Ability to interpret policies and procedures and communicate complex topics effectively.
- Computer and typing skills required.
- Bilingual in English and Spanish preferred.
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Utilization Review Nurse, FT Days
2 weeks ago
El Paso Children's Hospital Corporation El Paso, TX, United StatesTo monitor adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital services. Responsible for ensuring the appropriateness of hospital admissions and extended hospital stays. An understanding of the severity of an array of illnesse ...
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Utilization Review Nurse FT Days
2 weeks ago
El Paso Children's Hospital El Paso, United StatesTo monitor adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital services. Responsible for ensuring the appropriateness of hospital admissions and extended hospital stays. An understanding of the severity of an array of illnesse ...
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Customer Care Executive
2 weeks ago
Performix El Paso, United StatesJob Description: · Customer Project Specialist · M-F 8am-5pm · Job Overview: · This position is accountable for ensuring customers receive the best possible service. By reviewing order content and customer needs the individual commits to a shipment date. · Software aids in the de ...
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Sr Case Management Processor
6 days ago
Molina Healthcare El Paso, United StatesJob Description · Job Description · Job Summary · Responsible for working with members and providers to assess, facilitate, plan and coordinate the delivery of care across the continuum for members with potential risk for high cost and high utilization. Responsible for leading pr ...
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Mgr, Healthcare Services
6 days ago
Molina Healthcare El Paso, United StatesJob Description · JOB DESCRIPTION · Job Summary · Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long ...
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Full Time
2 weeks ago
The Hospitals of Providence El Paso, TX, United States Full timeThe Hospitals of Providence is seeking a Registered Nurse (RN) Case Management for a nursing job in El Paso, Texas. · Job Description & Requirements · ~ Specialty: Case Management · ~ Discipline: RN · ~ Duration: Ongoing · ~36 hours per week · ~ Shift: 12 hours · ~ Employm ...
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Registered Nurse Acute Care Medical PRN
1 week ago
Del Sol Medical Center El Paso, United StatesIntroduction · Do you currently have an opportunity to make a real impact with your work? With over 2,000 sites of care and serving over 31.2 million patient interactions every year, nurses at Del Sol Medical Center have the opportunity to make a real impact. As a(an) Acute Care ...
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Registered Behavior Technician
2 weeks ago
MECA Therapies LLC Santa Teresa, NM, United States*MECA Therapies , LLC is hiring for Behavior Technician (BT), Registered Behavior Technician (RBT), or Board-Certified Autism Technician (BCAT)* · The BA/RBT/BCAT is responsible for the delivery of ABA services to clients and families. Responsibilities will include direct service ...
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Coord. Quality Resources
3 weeks ago
University Medical Center of El Paso El Paso, United States ScheduleJob Summary · Executes activities for the following programs as directed by the Assistant Administrator Quality and Infection Control or designee: Quality and Performance Improvement, Patient Safety, Risk Management, Safety; collaborates with Quality and other leaders on survey r ...
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Educator - Critical Care (Surgical Hospital)
2 weeks ago
University Medical Center of El Paso El Paso, United StatesJob Summary · Assesses, plans, organizes, implements and evaluates orientation of new Associates. Assists with educational programs for all Associates within those specified departments. Functions as the liaison for nursing care areas, updates and reviews all nursing competencies ...
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Registered Nurse Acute Care Medical Surgical
3 days ago
Del Sol Medical Center Careers El Paso, United States Permanent, Full timeDescription · Introduction · Do you currently have an opportunity to make a real impact with your work? With over 2,000 sites of care and serving over 31.2 million patient interactions every year, nurses at Del Sol Medical Center have the opportunity to make a real impact. As a( ...
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PACU Nurse PRN
1 day ago
El Paso Surgery - East El Paso, United States SGRDescription · Introduction · Do you have the PRN career opportunities as a PACU Nurse you want with your current employer? We have an exciting opportunity for you to join El Paso Surgery - East which is part of the nation's leading provider of healthcare services, HCA Healthcare ...
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RN Service Coordinator
2 weeks ago
Optum El Paso, United States$1,000 Sign-on Bonus for external candidates · Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy ...
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Registered Nurse Surgical ICU
3 days ago
Las Palmas Medical Center Careers El Paso, United States Permanent, Full timeDescription · Surgical ICU - Cardiac and TransplantIntroduction · Are you looking for a place to deliver excellent care patients deserve? At Las Palmas Medical Center we support our colleagues in their positions. Join our Team as a Surgical ICU Registered Nurse and access progra ...
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Coder/Abstractor, CCS RHIT
3 weeks ago
University Medical Center of El Paso El Paso, United StatesJob Description: · The Coder/Abstractor, CCS, RHIT accurately codes, sequences and abstracts inpatient, outpatient, and emergency department records according to ICD-9-CM and CPT coding guidelines. Analyzes code assignment for correct DRG calculation to achieve optimal and timel ...
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Service Advisor
1 week ago
Hyundai of El Paso El Paso, United StatesOscar Leeser's Hyundai of El Paso · Service Advisor · As a fast growing dealership, we are expanding our shop to handle the increase in work. We are in need of a Service Advisor who understands the importance of customer service. Must be able to greet guests, schedule appointment ...
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Paralegal
3 weeks ago
El Paso County (TX) El Paso, United StatesRequirements · MOS Codes: Navy) · Education and Experience:An accredited Associate's degree or higher in paralegal or legal assistant studies, or a related field, plus three (3) years' experience as a paralegal or performing office support work in a legal setting. · Licenses and ...
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Nuclear Medicine Technician II
3 days ago
HCA Healthcare El Paso, United States Part timeDescription · Introduction · Do you want to join an organization that invests in you as a(an) Nuclear Medicine Technician II? At Las Palmas Medical Center, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the ...
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Paralegal-Real Estate
1 week ago
El Paso County (TX) El Paso, United StatesRequirements · MOS Codes: Navy) · Education and Experience:An accredited Associate's degree or higher in paralegal or legal assistant studies, or a related field, plus three (3) years' experience as a paralegal or performing office support work in a legal setting. · Licenses and ...
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Educator, PI Coordinator
2 weeks ago
University Medical Center of El Paso El Paso, United StatesJob Summary · Assesses, plans, organizes, implements and evaluates orientation and educational programs for Associates under area(s) of responsibility. In addition, fulfills responsibilities of an RN and functions as Performance Improvement liaison for area(s) of responsibility. ...
Utilization Reviewer - El Paso, United States - University Medical Center of El Paso
Description
Job SummarySupports the Utilization Management Program by applying effective and efficient processes for determining over/under-utilization and appropriateness of services for both medical and behavioral benefits to promote the highest level of physical, psychological, and social functioning possible for members and their families.
Under direction from the Chief Medical Officer and Medical Director, conducts prospective, concurrent, and/or retrospective utilization review functions. Identify members with special healthcare needs, and ensure timely referrals are completed for coordination of services and/or community resources. Maintains attuned to the identification of social determinants of health and refers Members, as necessary, to address their needs.Skills
Two years of clinical experience required.
License/Registration/Certification
Current, active, unrestricted license to practice as Licensed Nurse, Social Worker, Therapist, or BH Counselor in the State of Texas required.
Education and TrainingAssociate Licensed Nurse or bachelor degree in health care related field required.
Utilization Reviewer professionals in El Paso
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Luis Bermudez
Self motivated, coachable
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yahaira reyes
Software Developer II