• Utilization Management Nurse

    CenterWell (Austin, TX)
    …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** Healthcare isn't just about health ...medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
    CenterWell (11/13/25)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Fort Worth, TX)
    **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
    Molina Healthcare (10/17/25)
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  • Mgr Comprehensive Care RN

    Baylor Scott & White Health (Temple, TX)
    …coordinating patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and ... problem solving related to care coordination, discharge planning, case management and utilization review . Monitors processes and systems to ensure efficient… more
    Baylor Scott & White Health (12/04/25)
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  • Licensed Professional Mental Health…

    Veterans Affairs, Veterans Health Administration (Temple, TX)
    …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... and interactional patterns within the client system. This includes the utilization of testing measures where appropriate. -Provides counseling and/or psychotherapy… more
    Veterans Affairs, Veterans Health Administration (11/07/25)
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  • Mental Health Prof II Mast PRN

    HCA Healthcare (Corpus Christi, TX)
    …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical ... guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality… more
    HCA Healthcare (11/14/25)
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  • Care Manager RN (Delaware)

    Highmark Health (Austin, TX)
    …SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... utilization , identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors… more
    Highmark Health (12/12/25)
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  • Senior Decision Support Consultant

    Highmark Health (Austin, TX)
    …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... units that may assist in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the maintenance of the shared… more
    Highmark Health (11/14/25)
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  • Supv Comprehensive Care RN

    Baylor Scott & White Health (College Station, TX)
    …coordinating patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and ... FACTORS** Knowledge of Care Coordination, discharge planning, case management and utilization review . Knowledge of human behavior and performance; individual… more
    Baylor Scott & White Health (10/25/25)
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  • Supv Comprehensive Care SW

    Baylor Scott & White Health (College Station, TX)
    …coordinating patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and ... FACTORS** Knowledge of care coordination, discharge planning, case management and utilization review . Knowledge of human behavior and performance; individual… more
    Baylor Scott & White Health (10/25/25)
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  • UR Coordinator

    San Antonio Behavioral Health (San Antonio, TX)
    The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... status of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of… more
    San Antonio Behavioral Health (12/10/25)
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