• Denial Resource Center RN (Hybrid)

    Baylor Scott & White Health (Dallas, TX)
    …impact by taking initiative and delivering exceptional experience. **Job Summary** You, as a Registered Nurse in the Denial Resource Center at Baylor Scott & ... (Insurance) side of appeals and denials. + Experience in Utilization Review and Case Management. **Essential Functions of the...relevant work experience is preferred. + Applicants should be registered nurses. As a health care system committed to… more
    Baylor Scott & White Health (05/15/25)
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  • Home Health RN -Bonus Offered

    Home Care Providers of Texas (Leander, TX)
    Seeking Registered Nurse in the Leander/Austin, TX area! Zip Code 78641 Monday - Friday 8am - 5pm Sign on Bonus offered Have you ever felt overwhelmed at your ... to meet the needs of each individual patient. + Responsible for evaluating utilization of patient services and patient progress. Review evaluation with the care… more
    Home Care Providers of Texas (05/09/25)
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  • Home Health- RN -PRN Weekends Only

    Home Care Providers of Texas (Desoto, TX)
    Seeking for a PRN Home Health Registered Nurse for Weekdays and/or Weekends in the North Dallas, TX area! Are you seeking relief from the constant pressure and ... to meet the needs of each individual patient. + Responsible for evaluating utilization of patient services and patient progress. Review evaluation with the care… more
    Home Care Providers of Texas (04/25/25)
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  • Home Health RN - Full-time

    Home Care Providers of Texas (Round Rock, TX)
    Seeking Full-Time Home Health Registered Nurse in the North Austin, Round Rock TX and surrounding areas! Sign on Bonus Available Availability: Full Time ... to meet the needs of each individual patient. + Responsible for evaluating utilization of patient services and patient progress. Review evaluation with the care… more
    Home Care Providers of Texas (04/23/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (TX)
    …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (05/16/25)
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  • RN Clinical Consultant

    Guardian Life (Austin, TX)
    **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding disability by ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
    Guardian Life (05/06/25)
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  • Nurse Clinician IV ( RN ) - NICU…

    UTMB Health (Webster, TX)
    Nurse Clinician IV ( RN ) - NICU - CLC (FT Nights) **Webster, Texas, United States** Nursing & Care Management UTMB Health Requisition # 2502231 **REQUIRED ... EDUCATION & EXPERIENCE:** RN with bachelor's in...competent professional nursing practice as specified in the Texas Nurse Practice Act. Practice is characterized by a balance… more
    UTMB Health (04/19/25)
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  • Case Manager RN

    HCA Healthcare (San Antonio, TX)
    …of 3 years clinical experience in area in which Case Management will be performed. + RN License to practice as a professional registered nursing in the state of ... vary by location._** We are seeking a(an) Case Manager RN for our team to ensure that we continue...date.) + Prefer at least one year experience in utilization review, resource management, discharge planning or case management.… more
    HCA Healthcare (04/06/25)
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  • Care Review Clinician, Inpatient Review…

    Molina Healthcare (San Antonio, TX)
    …care/medical experience. R **equired License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. MULTI ... experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. **Preferred… more
    Molina Healthcare (05/09/25)
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  • Transplant Care Nurse RN - Stem…

    Highmark Health (Austin, TX)
    …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or… more
    Highmark Health (04/25/25)
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