• RN, Manager , Utilization

    Humana (Austin, TX)
    **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
    Humana (09/28/25)
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  • Clinical Learning Facilitator - Utilization

    Molina Healthcare (Houston, TX)
    …unrestricted State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified ... licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of training… more
    Molina Healthcare (09/17/25)
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  • Pharmacist, Utilization Management

    Molina Healthcare (Dallas, TX)
    … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/ Management staff work to ensure that Molina members...initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and… more
    Molina Healthcare (09/25/25)
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  • Director Utilization Management

    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 ... system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes...of Texas required upon hire ACM - Accredited Case Manager or CCM, CPHM or Milliman certification preferred upon… more
    Texas Health Resources (09/25/25)
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  • Utilization Management

    Elevance Health (Grand Prairie, TX)
    ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (09/25/25)
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  • Utilization Review RN - Hybrid

    Baylor Scott & White Health (Dallas, TX)
    …to fit their needs. + Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. ... in Microsoft Office and medical documentation systems. + Case management certifications, such as Certified Case Manager ,...Case management certifications, such as Certified Case Manager , are beneficial but not necessary for this position.… more
    Baylor Scott & White Health (08/29/25)
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  • Manager of Case Management

    HCA Healthcare (Fort Worth, TX)
    …**Job Summary and Qualifications** + Under the supervision of the Director of Case Management , the Case Management Manager performs case management ... Medical City Fort Worth team is looking for a Manager of Case Management . HCA Healthcare is...projects. + Works cooperatively with physicians to achieve the utilization of the case management plan. +… more
    HCA Healthcare (08/23/25)
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  • Case Manager (RN) | Case Management

    Houston Methodist (Houston, TX)
    …state, local and federal programs + Progressive knowledge of discharge planning, utilization management , case management , performance improvement and managed ... At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN)...registered nurse (RN) responsible for comprehensively planning for case management , which includes care transitions and discharge planning of… more
    Houston Methodist (08/30/25)
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  • Senior Manager , Digital Product…

    7-Eleven (Irving, TX)
    Senior Manager , Digital Product Management - Retail Media Apply Now (https://my7elevenhr.wd12.myworkdayjobs.com/Careers/job/SSC-Irving-TX/Sr- Manager ... a lasting change, and that change starts with you. Responsibilities of a Senior Manager , Product Management for Retail Media include : + Retail Media Strategy… more
    7-Eleven (09/16/25)
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  • Manager Care Management

    AdventHealth (Mansfield, TX)
    …**Location:** 2300 Lonestar RD, Mansfield, TX 76063 **The role you'll contribute:** "The Care Management Manager is under the general leadership of the Care ... daily operations and supervision of team members. The Care Management Manager is responsible for, but not...degree + 3 years of experience in direct Care Management / Utilization Management experience in an… more
    AdventHealth (09/19/25)
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