• Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (San Antonio, TX)
    + Level Description' Management ' Leveling Guide consists of jobs with the responsibility, accountability, and decision-making authority to develop and implement ... with implementation of policies and procedures for the clinical staff.Impact* Management of professionals and support staff. Responsible for setting objectives for… more
    Fresenius Medical Center (12/13/25)
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  • Registered Nurse III

    MTC (Raymondville, TX)
    …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... of all medical records. Observe applicable HIPAA rules. + Review medical files to determine all provided services are...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
    MTC (01/01/26)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Waco, TX)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (01/06/26)
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  • Care Review Clinician (RN)

    Molina Healthcare (San Antonio, TX)
    …room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At… more
    Molina Healthcare (12/13/25)
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  • Medical Director (Medicare)

    Molina Healthcare (Dallas, TX)
    …learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed care experience. * Peer review experience. * ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
    Molina Healthcare (01/07/26)
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  • Care Review Clinician (RN)

    Molina Healthcare (TX)
    …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support… more
    Molina Healthcare (12/24/25)
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  • Interim Director of Case Management

    HealthTrust Workforce Solutions (San Antonio, TX)
    …budget and resource management , cost control, contract compliance, quality improvement, utilization management , denials management and management of ... jobs nationwide. **_JOB SUMMARY_** The Interim Leader of Case Management Services is a Registered Nurse who...that the following functions of the role are completed: Utilization Review for medical necessity of admission… more
    HealthTrust Workforce Solutions (01/08/26)
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  • Director Case Management

    HCA Healthcare (Irving, TX)
    …and personal growth, we encourage you to apply for our Director Case Management opening. We promptly review all applications. Highly qualified candidates will ... like family! Jump-start your career as a Director Case Management today with Medical City Las Colinas. **Benefits** Medical...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of… more
    HCA Healthcare (12/10/25)
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  • Care Management Associate

    CVS Health (Austin, TX)
    …management team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases ... all with heart, each and every day. **Position Summary** The Care Management Associate (CMA) supports comprehensive coordination of medical services that include… more
    CVS Health (01/01/26)
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  • Mgr Comprehensive Care RN

    Baylor Scott & White Health (Temple, TX)
    …for assessing and coordinating patient care across the continuum to include case management , social work, utilization review and care coordination to ... problem solving related to care coordination, discharge planning, case management and utilization review . Monitors...5 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse (RN) As a health care system committed to… more
    Baylor Scott & White Health (12/04/25)
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