NewCase Management Manager University HealthCase Management ManagerSan Antonio, TXRequired experience: minimum of two years recent management experience; three years of hospital clinical nursing experience and one year experience in case management, utilization review or hospital quality assurance. Manages the care coordinators (case managers), home health coordinators and clerical staff to insure a smooth patient flow from preadmission to discharge and follow up in accordance with the patient’s and the payers requirements.
staff - Director Registered Nurse (RN) - Case Management - $38-53 per hour Baptist Health System - San Antonio TXstaff - Director Registered Nurse (RN) - Case Management - $38-53 per hourSan Antonio, TX$38–$53 / hourResponsible for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. Baptist Health System - San Antonio TX is seeking a Registered Nurse (RN) Case Management Director for a nursing job in San Antonio, Texas.
NewNurse Case Manager University HealthNurse Case ManagerBoerne, TXFacilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Two years experience in any case management care setting; HMO, Physician Group Model, MSO, or Acute Care is required.
NewManager, Population Health Management RN University HealthManager, Population Health Management RNSan Antonio, TXManages, supervises and assists the Director Clinical Services - Case Management with oversight of Case Management staff in the Population Health Management department to facilitate high-quality, cost-effective care for Community First Health Plans, Inc. (Community First) STAR, CHIP, Medicare, EPO Members. Seven years of clinical nursing case management/service coordination experience with two years of management experience is required.
NewNurse Case Manager - CFHP University HealthNurse Case Manager - CFHPBoerne, TXResponsibilities include but are not limited to: overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible.
NewClinical Reviewer Utilization Management University HealthClinical Reviewer Utilization ManagementSan Antonio, TXExperience reviewing Medicaid, Medicare, Marketplace, Commercial, CHIP, Dual Eligible Special Needs Plans (D-SNP), or other government-sponsored healthcare programs preferred. Performs utilization management activities including prior authorization review, concurrent review, retrospective review, and appeal review activities utilizing approved medical necessity criteria, organizational policies, contractual requirements, and regulatory guidelines.
NewClinical Reviewer, Utilization Management University HealthClinical Reviewer, Utilization ManagementSan Antonio, TXResponsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible.
NewMedical Director, Utilization Management- CFHP University HealthMedical Director, Utilization Management- CFHPSan Antonio, TXActively participates with staff across the organization – this is essential to facilitate integrated service delivery, planning, quality assurance, and risk management and to address the needs of members and their families to protect and promote the healthcare of members. This position provides clinical leadership and oversight of the population health management program including utilization management, case management, preventive health/disease management, and quality management while supporting the multidisciplinary member-centric approach to care management.
NewClinical Reviewer Utilization Management University Health CareersClinical Reviewer Utilization ManagementSAN ANTONIO, TXExperience reviewing Medicaid, Medicare, Marketplace, Commercial, CHIP, Dual Eligible Special Needs Plans (D-SNP), or other government-sponsored healthcare programs preferred. Performs utilization management activities including prior authorization review, concurrent review, retrospective review, and appeal review activities utilizing approved medical necessity criteria, organizational policies, contractual requirements, and regulatory guidelines.
NewClinical Reviewer, Utilization Management University Health CareersClinical Reviewer, Utilization ManagementSAN ANTONIO, TXResponsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible.
NewCare Coordination Manager University HealthCare Coordination ManagerSan Antonio, TXA minimum of one year recent management or senior social worker is required with 3 years of hospital (inpatient) experience. Manages assigned staff to insure a smooth patient flow from preadmission to discharge and follow up in accordance with the patient’s and the payers requirements.
NewRegistered Nurse Case Manager (RN) - Case Management Tenet Healthcare CorpRegistered Nurse Case Manager (RN) - Case ManagementSan Antonio, TXOur system of care includes six full-service hospitals, a specialized childrens hospital with a dedicated pediatric emergency unit, a comprehensive cancer care network, fitness and rehabilitation centers, a physician network, imaging centers, ambulatory services and the Baptist School of Health Professions. Responsible to facilitate care along a continuum through effective resource coordination to help patient achieve optimal health, access to care and appropriate utilization of resources balanced with the patient's resources and right to self-determination.
Care Manager II - Case Management CHRISTUS HealthCare Manager II - Case ManagementNew Braunfels, TXGraduate of an accredited school of nursing (BSN preferred) or Masters Degree in Social Work (MSW) required or demonstrated success in CHRISTUS Care Manager I Position for at least 5 years on top of the required experience in lieu of education required. The Care Manager (CM) II works in collaboration with the patient/family, physicians and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge.
NewNurse (Clinical/Case Management) U.S. Department of DefenseNurse (Clinical/Case Management)San Antonio, TX$67,970–$88,356 / yearFOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. In addition to meeting the basic requirement above, to qualify for this position you must also meet the qualification requirements listed below: Education/Experience: A diploma, associate degree, or bachelors degree in Nursing from a professional nursing program and possession of at least one full year of professional nursing experience (equivalent to the GS-9 grade level or above) which includes coordinating patient care, educating patients or staff, and assisting with developing patient care plans.
Director of Case Management Saint Luke's HospitalDirector of Case ManagementSan Antonio, TXResponsible for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. Our system of care includes six full-service hospitals, a specialized childrens hospital with a dedicated pediatric emergency unit, a comprehensive cancer care network, fitness and rehabilitation centers, a physician network, imaging centers, ambulatory services and the Baptist School of Health Professions.
Case Management Specialist MAVAGI ENTERPRISES INCCase Management SpecialistSan Antonio, TXWe are a mission-driven, people-first organization and we are looking for a Case Management Specialist who moves with urgency, documents with precision, and genuinely cares about the humans whose files sit on their desk. If you don't check every box but you have a track record of doing careful work with vulnerable populations, communicating without being asked, and finishing what you start, we still want to hear from you.
Director - Case Management Tenet Healthcare CorpDirector - Case ManagementSan Antonio, TXResponsible for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. Our system of care includes six full-service hospitals, a specialized childrens hospital with a dedicated pediatric emergency unit, a comprehensive cancer care network, fitness and rehabilitation centers, a physician network, imaging centers, ambulatory services and the Baptist School of Health Professions.
Care Manager - Case Management Christus HealthCare Manager - Case ManagementSan Antonio, TXToggle Mobile Navigation Menu. Non-Clinical Careers.
Emergency Department Care Manager - Case Management Christus HealthEmergency Department Care Manager - Case ManagementNew Braunfels, TXToggle Mobile Navigation Menu. Non-Clinical Careers.
Case Manager VQCase ManagerSan Antonio, TexasThe Case Manager plays a crucial role in supporting youth and families by linking them to community resources, engaging youth in prosocial activities, supporting life skills development, and empowering families to engage with their local community. May participate in team after hours support rotation, providing immediate response to urgent needs and maintaining continuity of care outside scheduled sessions.