• Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical… more
    Molina Healthcare (09/06/25)
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  • Director of Nursing Oncology

    HCA Healthcare (San Antonio, TX)
    …changes and evaluate outcomes of process improvement activities. The Director of Nursing models behavior consistent with the MHS management philosophy. ... acute care experience **Preferred** : + Master's Degree in Nursing or related field; + 1-year management ...management experience as a charge RN, clinical care manager /supervisor, or manager . **Minimum License, Certificates, or… more
    HCA Healthcare (09/19/25)
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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...Bachelor's degree preferred **WORK EXPERIENCE** + Three years hospital nursing clinical experience + Case management experience… more
    Houston Methodist (08/30/25)
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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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  • 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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  • Manager , Healthcare Services

    Molina Healthcare (TX)
    …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
    Molina Healthcare (09/27/25)
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  • Manager of Case Management

    HCA Healthcare (Dallas, TX)
    …2,000 sites of care in 21 states and the United Kingdom. We are looking for a Manager of Case Management for our Medical City Heart & Spine Hospitals team where ... to be an influencer in healthcare? **Apply for our Manager of Case Management role today!** **Job...supporting a balance of optimal care and appropriate resource utilization .​ **What qualifications you will need:** **Education & Experience:**… more
    HCA Healthcare (09/17/25)
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  • RN Case Manager PRN Inpatient Rehab

    HCA Healthcare (Dallas, TX)
    …+ Certification in Case Management preferred + 2+ years experience in Case Management OR 3+ years experience in clinical nursing Medical City Dallas is ... other healthcare provider. We are seeking an RN Case Manager PRN Inpatient Rehab to join our healthcare family....nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
    HCA Healthcare (08/09/25)
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  • Care Manager RN

    Covenant Health (Lubbock, TX)
    …Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation ... RN** **The Care Manager RN provides professional, comprehensive, patient centric care management services for at risk patients in an acute care environment.… more
    Covenant Health (09/24/25)
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  • RN Care Manager - Pediatrics, STAR Kids

    Centene Corporation (Lubbock, TX)
    …a fresh perspective on workplace flexibility. **Care Manager - Registered Nurse work in Lubbock, TX** **Pediatric Nursing experience is required.** **Monday ... NP - Nurse Practitioner - Current State's Nurse Licensure required + For Superior: Resource Utilization...ER, Pediatric Private Duty Nursing , or School Nurse + Case Management + Service Coordination… more
    Centene Corporation (09/20/25)
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