• Utilization Management Nurse

    CenterWell (Austin, TX)
    …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
    CenterWell (11/13/25)
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  • Case Manager RN

    HCA Healthcare (San Antonio, TX)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Case Manager RN with Methodist Hospital Texsan you can be a part of ... our organization. We are looking for an enthusiastic Case Manager RN to help us reach our...performed. + Prefer at least one year experience in utilization review , resource management, discharge planning or… more
    HCA Healthcare (10/02/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Austin, TX)
    …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
    Molina Healthcare (11/14/25)
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  • RN Case Manager

    Erickson Living (Dallas, TX)
    …of medical practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that ... by Erickson Senior Living Join our team as a RN Case Manager (also known as Care...+ Researches and selects care options as appropriate. The nurse care coordinator may utilize a range of alternative,… more
    Erickson Living (11/15/25)
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  • RN PRN PCU/MS Days or Nights

    AdventHealth (Burleson, TX)
    …vacation during commitment period. No approved time off during holiday weeks. Must provide manager 4 weeks notice for vacation requests. ** RN Tier 4 CSO PRN** ... Up to $55/hr - Experienced RN PCU/MS PRN **All the benefits and perks...No approved time off during holiday weeks. Must provide manager 4 weeks notice for vacation requests **The community… more
    AdventHealth (11/13/25)
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  • Case Manager - PRN

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a target ... department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (11/07/25)
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  • Case Manager Certified - Transition in Care

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse ( RN ) responsible for comprehensively planning for case management of ... engagement, ie peer-to-peer accountability. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (10/11/25)
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  • Rehab Case Manager

    HCA Healthcare (El Paso, TX)
    …**Are you passionate about delivering patient-centered care?** Submit your application for Registered Nurse Case Manager Rehab position and spend ... serves as a liaison between medical staff, administration, utilization review , nursing, finance, medical records and...in your career! We are interviewing candidates for our Registered Nurse Case Manager Rehab… more
    HCA Healthcare (11/14/25)
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  • Nurse Manager II - PCU

    Texas Health Resources (Dallas, TX)
    ** Nurse Manager II - PCU** _Are...Supervisory or Managerial Experience Strongly Preferred **Licenses and Certifications** RN - Registered Nurse Upon ... Center of Excellence in Robotic Surgery by the Surgical Review Corporation (SRC), a leading organization dedicated to advancing...Degree Nursing Required **Experience** 3 Years Experience as a registered nurse with previous experience as a… more
    Texas Health Resources (10/16/25)
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  • Case Manager - Inpatient Rehab - PRN

    Texas Health Resources (Dallas, TX)
    …years' clinical experience required. * One year of hospital case management experience is preferred. * RN - Registered Nurse Upon Hire Req or LMSW - Licensed ... Case Manager - Inpatient Rehabilitation _Bring your passion to...resources. Assesses patient information utilizing psychological and medical knowledge. Utilization Review and Management * Performs effective… more
    Texas Health Resources (10/23/25)
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