• Inpatient Auth Review Services RN…

    HCA Healthcare (Plano, TX)
    …The IPAT Clinical Analyst Registered Nurse or Licensed Practical Nurse will review post discharge, prebill accounts that do not have authorization ... the account in accordance with policies and procedures. Escalate medical review request and /or denial activities...care contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the… more
    HCA Healthcare (10/31/25)
    - Related Jobs

  • Medical Claim Review Nurse…

    Molina Healthcare (San Antonio, TX)
    …will work on set schedule) Looking for a RN with experience with appeals , claims review , and medical coding. **Job Summary** Utilizing clinical knowledge ... and experience, responsible for review of documentation to ensure medical necessity...state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (09/06/25)
    - Related Jobs

  • Care Review Clinician ( RN )

    Molina Healthcare (Houston, TX)
    For this position we are seeking a ( RN ) Registered Nurse who...Looking for a RN with experience with appeals , claims review , and medical ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
    Molina Healthcare (11/01/25)
    - Related Jobs

  • RN Medical Claim Review…

    Molina Healthcare (San Antonio, TX)
    JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely ... including diagnosis. Candidates with knowledge of CPT/HCPCS codes, record review , chart audit, provider disputes, appeals , and...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (10/19/25)
    - Related Jobs

  • Clinical Registered Nurse…

    Cognizant (Austin, TX)
    …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...the medical necessity determinations to the Health Plan/ Medical Director based on the review of… more
    Cognizant (10/07/25)
    - Related Jobs

  • Registered Nurse Case Manager IP…

    HCA Healthcare (Plano, TX)
    …worth of each individual is recognized. Submit your application for the opportunity below: Registered Nurse Case Manager IP RehabMedical City Plano **Benefits** ... benefits may vary by location._** We are seeking a(an) Registered Nurse Case Manager IP Rehab for...Nurse Case Manager IP Rehab opening. We promptly review all applications. Highly qualified candidates will be directly… more
    HCA Healthcare (10/21/25)
    - Related Jobs

  • Denial Resource Center RN

    Baylor Scott & White Health (Dallas, TX)
    **JOB SUMMARY** The Denial Resource Center Registered Nurse ( RN ) is responsible for Baylor Scott & White Health denial management functions. The Denial ... - Associate's - EXPERIENCE - 2 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - Registered Nurse ( RN ) Hybrid expectation- On-site once a year… more
    Baylor Scott & White Health (10/31/25)
    - Related Jobs

  • Associate Manager RN Denials Management

    Banner Health (TX)
    …Requires a level of education as normally demonstrated by a Bachelor's degree. Requires Registered Nurse ( RN ) licensure in the state of practice. Requires ... work and receive care. As an Associate Manager of RN Denials Management, you will be an integral part...questions from your team and outside stakeholders, and conducting review of findings. In this role you will have… more
    Banner Health (11/01/25)
    - Related Jobs

  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... review , case management or equivalent revenue cycle clinical role + Experience includes writing clinical appeals for medical necessity compliance or level of… more
    Houston Methodist (10/29/25)
    - Related Jobs

  • Senior Director Case Management

    Houston Methodist (Houston, TX)
    …leading multi-site or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the… more
    Houston Methodist (10/16/25)
    - Related Jobs