• Utilization Review Nurse

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse ( RN ) who comprehensively conducts point of ... management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (07/12/25)
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  • Concurrent Review Nurse

    Actalent (Houston, TX)
    Job Title: Review Nurse Job Description The ...InterQual. + Active Compact RN License. + Utilization Management /Concurrent Review experience. + ... to ensure the successful completion of cases. Essential Skills + Experience in utilization management , concurrent review , prior authorization, utilization more
    Actalent (08/08/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (TX)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (08/08/25)
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  • Care Review Clinician, PA ( RN

    Molina Healthcare (Fort Worth, TX)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (07/17/25)
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  • Program Mgr UR/Case Management - CMC…

    UTMB Health (Friendswood, TX)
    …ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical ... manner. **_ESSENTIAL JOB FUNCTIONS_** **:** + Supervises the operational management of the Utilization Review /Case...Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum… more
    UTMB Health (08/01/25)
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  • Case Manager - Registered Nurse

    CVS Health (Austin, TX)
    …Must be able to obtain multi state Registered Nurse ( RN ) licensures **Preferred Qualifications** + Case Management Certification + Transplant experience ... and every day. **Position Summary** This Case Manager - Registered Nurse ( RN ) position is...blended role doing both Case Management and Utilization Management . The RN Case… more
    CVS Health (08/08/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Houston, TX)
    …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
    Fresenius Medical Center (07/30/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Marble Falls, 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 (08/08/25)
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  • Registered Nurse Case Manager PRN

    HCA Healthcare (Austin, TX)
    …opportunity. We want your knowledge and expertise! **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is responsible for promoting ... RN license; 6 Months to obtain TX RN license + Certification in Case Management ...encourage you to apply for our Registered Nurse Case Manager PRN opening. We review more
    HCA Healthcare (06/21/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Denton, TX)
    …City Denton we support our colleagues in their positions. Join our Team as a Registered Nurse Case Manager and access programs to assist with every stage of ... gain certifications and job skills. Apply today for our Registered Nurse Case Manager opening and continue...Nurse Case Manager opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
    HCA Healthcare (08/02/25)
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