• Medical Director

    Molina Healthcare (San Antonio, TX)
    …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... national, state, and local laws and regulatory requirements affecting the medical and clinical staff. + Marketplace UM reviews + MD licenses required for the… more
    Molina Healthcare (10/17/25)
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  • Senior Solution Architect, Nursing - Build,…

    Oracle (Austin, TX)
    …(ECD) alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal ... of analysts providing support for operationally required changes and enhancements to clinical applications, and aa group of analysts leading projects that will… more
    Oracle (11/25/25)
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  • Medical Director (NV)

    Molina Healthcare (Fort Worth, TX)
    …requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial process. * Monitors appropriate care ... for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership and consultation… more
    Molina Healthcare (11/21/25)
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  • Med Mgmt Clinician Sr (US)

    Elevance Health (Grand Prairie, TX)
    … clinical staff. + Conducts and may approve pre-certification, concurrent , retrospective, out of network and/or appropriateness of treatment setting reviews ... not require the training or skill of a registered nurse . Acts as a resource for more junior Clinicians....equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. +… more
    Elevance Health (12/03/25)
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  • RN Coordinator Trauma PI

    HCA Healthcare (Corpus Christi, TX)
    …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... and Patient Safety (PIPS) Program. The PI Coordinator will review the continuum of care to determine compliance with...trauma patients. + Serve as a liaison to the clinical areas responsible for trauma patients. + Coordinate multidisciplinary… more
    HCA Healthcare (10/25/25)
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  • Director of Nursing / DON

    BrightSpring Health Services (Harlingen, TX)
    …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... monitoring both skilled and non-skilled healthcare services + Directly supervises clinical personnel + Providing clinical teaching and conducting performance… more
    BrightSpring Health Services (11/26/25)
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  • Case Manager Austin Market Float Pool

    HCA Healthcare (Austin, TX)
    …of medical services and discharge planning for specified patient populations. Performs concurrent and retrospective review of patient medical records for ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...purposes of utilization review , care coordination compliance with requirements of external … more
    HCA Healthcare (11/27/25)
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  • Case Manager Austin Market Float Pool

    HCA Healthcare (Austin, TX)
    …of medical services and discharge planning for specified patient populations. Performs concurrent and retrospective review of patient medical records for ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...purposes of utilization review , care coordination compliance with requirements of external … more
    HCA Healthcare (09/19/25)
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