• Non-Clinical Coding and OASIS Review

    BAYADA Home Health Care (Austin, TX)
    …+ Candidates should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...Coding_ **As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all… more
    BAYADA Home Health Care (07/01/25)
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  • Care Review Clinician, Inpatient…

    Molina Healthcare (Houston, TX)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in the state of Texas. You will be hired to join the inpatient review team doing ... state or locality with reliable transportation. **State Specific Requirements:** IL Qualifications: Licensed within the state of Illinois or will apply for licensure… more
    Molina Healthcare (08/08/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Austin, TX)
    …your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...Coder, Medicare **As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all… more
    BAYADA Home Health Care (07/01/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Fort Worth, TX)
    …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... unrestricted State Registered Nursing (RN) license in good standing. Must be licensed for CALIFORNIA. **WORK SCHEDULE: California NON RESIDENTS must work CALIFORNIA… more
    Molina Healthcare (07/17/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
    Houston Methodist (07/31/25)
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  • Physician Advisor

    CommonSpirit Health (Houston, TX)
    …and you must be licensed in the state of Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred by case ... objectives for providing quality patient care, to assure effective and efficient utilization of health care services. The PA communicates remotely with case and… more
    CommonSpirit Health (06/28/25)
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  • Clinical Case Manager, Behavioral Health

    CVS Health (Austin, TX)
    …Case management and discharge planning experience + Crisis intervention skills + Managed care/ utilization review experience + Ability to take and manage crisis ... and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of… more
    CVS Health (08/10/25)
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  • Director of Rehab

    Genesis Healthcare (Dallas, TX)
    …clinical utilization , and patient identification is overseen by a licensed therapist. 20. Performs other related duties as required. Qualifications 1. Graduate ... Clinical Operations Area Director in the timely completion of the annual merit review for therapy staff. 6. Assists Clinical Operations Area Director in the hiring… more
    Genesis Healthcare (07/31/25)
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  • Behavioral Health Provider (O-6 Billet)…

    Immigration and Customs Enforcement (Los Fresnos, TX)
    …health assessment, evaluation, and diagnosis of detained non-citizens (including the utilization of the DSM-V to formulate findings). Provides supportive counseling, ... electronic medical record (EMR) to complete clinical documentation, and to review and process telephone encounters, etc. Promotes and facilitates multidisciplinary… more
    Immigration and Customs Enforcement (07/30/25)
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  • Director of Case Management & Social Services RN…

    Houston Methodist (Houston, TX)
    …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... most clinically appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs… more
    Houston Methodist (08/02/25)
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