• Utilization Management Nurse…

    CVS Health (Austin, TX)
    …with Microsoft Office Applications (Outlook, Teams, Excel) **Preferred Qualifications** + Prior authorization utilization experience preferred + Outpatient ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external… more
    CVS Health (07/30/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (San Antonio, TX)
    …services to ensure level of care and services are medically appropriate + Performs prior authorization reviews related to mental health and substance abuse to ... Texas BHEC as an LPC, LCSW, or LMFT. Registered Nurse must have direct psychiatric/mental health work experience and...Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members… more
    Centene Corporation (07/31/25)
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  • Care Review Clinician, Prior Auth (RN) Pega…

    Molina Healthcare (Houston, TX)
    …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization… more
    Molina Healthcare (07/12/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Fort Worth, TX)
    …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization… more
    Molina Healthcare (07/17/25)
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  • Clinical Pharmacist

    HCA Healthcare (Jourdanton, TX)
    …applicable). Minimum License, Certificates, or Registrations Required: ONE of the following prior to the first day of employment: A. Current Registered Pharmacist ... Licensed pharmacist in another state: Provide proof of the Authorization to Test (ATT) from the Texas State Board...as needed to include timely notification of physician and nurse . 3. Provides continual guidance to technical staff as… more
    HCA Healthcare (06/21/25)
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