• RN Clinical Appeals Nurse

    Molina Healthcare (Dallas, TX)
    …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (09/26/25)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (San Antonio, TX)
    …state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing. ... **JOB DESCRIPTION** Looking for a RN that has a current active unrestricted license...documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations,… more
    Molina Healthcare (09/06/25)
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  • Care Manager I - Transition…

    Houston Methodist (Houston, TX)
    …Houston Methodist, the Care Manager I position is a licensed registered nurse ( RN ) who works collaboratively with the interprofessional healthcare ... (ED) visits and readmissions while improving patient satisfaction. The Care Manager I position promotes and maintains...care preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (09/09/25)
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  • RN - Pre-Surgery Holding PRN

    AdventHealth (Mansfield, TX)
    …hospital protocol and physician orders regarding use of restraints. Reports any safety concerns to Care Manager and Charge Nurse . Functions in a safe manner. ... ages, and a growing business community. **The role you'll contribute:** The Outpatient Surgery RN practices as a professional nurse within the limits of the… more
    AdventHealth (09/19/25)
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  • Manager Care Management

    AdventHealth (Mansfield, TX)
    ** Manager Care Management Texas Health Mansfield Affiliate of...Bachelors of Social Work and Masters in related field + RN - Registered Nurse - State ... RD, Mansfield, TX 76063 **The role you'll contribute:** "The Care Management Manager is under the general...BSN degree + 3 years of experience in direct Care Management/ Utilization Management experience in an acute… more
    AdventHealth (09/19/25)
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  • Nurse Manager of Critical…

    HCA Healthcare (Decatur, TX)
    …our team. **Job Summary and Qualifications** The Registered Nurse Manager is responsible for promoting patient-centered care by coordinating the plan of ... **Description** **Medical City Decatur** Nurse Manager of Critical Care...and patient throughput while supporting a balance of optimal care and appropriate resource utilization . Follows the… more
    HCA Healthcare (08/21/25)
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  • Case Manager

    Apex Health Solutions (Houston, TX)
    …TX area; will consider remote deployment on a case by case basis Education Education: Registered Nurse ( RN ) LICENSES/CERTIFICATIONS: Registered Nurse ... Using a defined process to identify patients/members at risk for poor outcomes, the Case Manager establishes care plans and goals, and coordinates care and… more
    Apex Health Solutions (08/24/25)
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  • Manager Nursing - Critical Care

    Catholic Health Initiatives (Bryan, TX)
    …of care . **Job Requirements** Required Education and Experience: *Bachelor's Degree and Registered Nurse Starting in January of 2016, any new hires should ... employees. 6.Has an identified council structure with an elected Staff Nurse Professional Practice Council representative. Conducts unit council meetings monthly… more
    Catholic Health Initiatives (09/14/25)
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  • Transfer Center Point of Entry Nurse - Mid…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Point of Entry Nurse (POE) is a licensed registered nurse ( RN ) who responsible for facilitation of the functional and ... degree preferred **WORK EXPERIENCE** + Two years as a registered nurse in an acute care...experience highly preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (07/21/25)
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  • Manager , Healthcare Services

    Molina Healthcare (TX)
    …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... integrated) performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
    Molina Healthcare (09/27/25)
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