• RN, Manager , Utilization Management…

    Humana (Austin, TX)
    …Registered Nurse (RN) license in the state of Michigan. + Previous experience in utilization management and/or utilization review . + Minimum of two (2) ... caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization...procedures to provide the best and most appropriate treatment, care , or services for members. + Hire, train, coach,… more
    Humana (09/28/25)
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  • Director Utilization Management-Clinical…

    Texas Health Resources (Arlington, TX)
    Director Utilization Management-Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... leader for system services for wholly owned and Partner hospitals for utilization management. Job Duties OPERATIONS: Plans, organizes and delegates activities as… more
    Texas Health Resources (09/25/25)
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  • Utilization Review RN - Hybrid

    Baylor Scott & White Health (Dallas, TX)
    …the provider's care coordination departments. Your expertise is needed to review medical necessity. + Working with the team, you'll verify medical records ... Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care . + Excellent communication… more
    Baylor Scott & White Health (08/29/25)
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  • Pharmacist, Utilization Management (UM)…

    Molina Healthcare (Dallas, TX)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
    Molina Healthcare (09/25/25)
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  • Care Manager RN

    Covenant Health (Lubbock, TX)
    **Description** ** Care Manager RN** **The Care ...3 years of hire. + 1 year of experience in care management or utilization review in ... assessment and planning, coordination of care , resource utilization management and/ or review , discharge planning,...position:** + This posting includes multiple openings for a ** Care Manager RN** + Available Shifts: +… more
    Covenant Health (09/24/25)
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  • Case Manager Certified - Transition…

    Houston Methodist (Houston, TX)
    …approved utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. Reviews level of care ... effectively. Proactively takes action to achieve continuous improvement and expedite care /facilitate discharge. + Performs post-discharge review by analyzing the… more
    Houston Methodist (09/27/25)
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  • Social Work Care Manager

    AdventHealth (Mansfield, TX)
    …and a growing business community. **The role you'll contribute:** The Social Work Care Manager intervenes with patients who have complex psychosocial needs, ... career with AdventHealth, named in 2018 by Beckers Hospital Review as one of the 150 Top Places to...of the care team). The Social Work Care Manager , in collaboration with the patient/family,… more
    AdventHealth (10/03/25)
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  • RN Registered Nurse Care Manager

    AdventHealth (Mansfield, TX)
    …ages, and a growing business community. **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... career with AdventHealth, named in 2018 by Beckers Hospital Review as one of the 150 Top Places to...care coordination and progression through the continuum of care . The RN Care Manager … more
    AdventHealth (09/25/25)
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  • RN Registered Nurse Care Manager

    AdventHealth (Killeen, TX)
    …be caring for:** AdventHealth Central Texas **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, ... care coordination and progression through the continuum of care . The RN Care Manager ...physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge… more
    AdventHealth (10/02/25)
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  • Manager Care Management

    AdventHealth (Mansfield, TX)
    ** Manager Care Management Texas Health Mansfield Affiliate of AdventHealth** **All the benefits and perks you need for you and your family:** + Benefits from Day ... 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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