• LTSS Service Coordinator - RN

    Elevance Health (Mesquite, TX)
    …unless an accommodation is granted as required by law._ The **LTSS Service Coordinator- RN ** is responsible for overall management of member's case within the ... **LTSS Service Coordinator - RN ** **Location:** The location for this position is...face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health,… more
    Elevance Health (08/23/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Dallas, TX)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
    Molina Healthcare (09/26/25)
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  • Nurse Clinician IV ( RN ) - ED…

    UTMB Health (League City, TX)
    Nurse Clinician IV ( RN ) - ED League City (10A-10P) **League City, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2505385 ... **REQUIRED EDUCATION & EXPERIENCE:** RN with bachelor's in nursing,...competent professional nursing practice as specified in the Texas Nurse Practice Act. Practice is characterized by a balance… more
    UTMB Health (09/27/25)
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  • 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. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (09/06/25)
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  • Transitions of Care - RN , 100% Virtual,…

    Elevance Health (TX)
    …patients with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + ... **Transitions of Care - RN , 100% Virtual, CareBridge** Location: This role enables...for participating in delivery of patient education and disease management interventions and for performing health coaching for members,… more
    Elevance Health (10/01/25)
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  • RN - Pre-Surgery Holding PRN

    AdventHealth (Mansfield, TX)
    …except on weekends when not here. Stocks the outpatient rooms daily as evidenced by nurse management . Performs opening or closing of the unit duties daily, as ... business community. **The role you'll contribute:** The Outpatient Surgery RN practices as a professional nurse within...use of restraints. Reports any safety concerns to Care Manager and Charge Nurse . Functions in a… more
    AdventHealth (09/19/25)
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  • Case Manager Certified - Transition in Care

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse ( RN ) responsible for comprehensively planning for case management ... management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management , performance… more
    Houston Methodist (09/27/25)
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  • Manager Care Management

    AdventHealth (Mansfield, TX)
    …Bachelor's of Nursing OR + Bachelors of Social Work and Masters in related field + RN - Registered Nurse - State Licensure and/or Compact State Licensure if ... Mansfield, TX 76063 **The role you'll contribute:** "The Care Management Manager is under the general leadership...degree + 3 years of experience in direct Care Management / Utilization Management experience in an… more
    AdventHealth (09/19/25)
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  • Case Manager

    Apex Health Solutions (Houston, TX)
    …TX area; will consider remote deployment on a case by case basis Education Education: Registered Nurse ( RN ) LICENSES/CERTIFICATIONS: Registered Nurse ... and cooperates with internal and external stakeholders. Collaborates effectively with Utilization Management , Quality Management , Pharmacy, Provider… more
    Apex Health Solutions (08/24/25)
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  • Manager , Care Integration Team

    CenterWell (Dallas, TX)
    …of professional experience + 2 or more years of management experience + Active Registered Nurse ( RN ) license or Social Work (SW) license + Proficiency in ... for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred… more
    CenterWell (09/17/25)
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