• Utilization Management Nurse

    CVS Health (TX)
    …and organizational skills - Proficiency with electronic medical records and utilization review systems **Required Qualifications** - Must have active, ... **Preferred Qualifications** - Certification in Neonatal Intensive Care Nursing (RNC-NIC) or Utilization Review - Prior experience in managed care or health… more
    CVS Health (01/16/26)
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  • Director of Case Management & Social…

    Houston Methodist (The Woodlands, TX)
    …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse - Texas State Licensure ... At Houston Methodist, the Director Case Management & Social Services RN ...excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of… more
    Houston Methodist (01/16/26)
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  • Care Manager RN - Case Management

    Covenant Health (Lubbock, TX)
    …Qualifications:** + Upon hire: Associate's Degree in Nursing degree/diploma. + Upon hire: Texas Registered Nurse License - if practicing within this state. + 2 ... **Description** **Care Manager RN - Case Management** **$10,000 hiring...+ 1 year of experience in care management or utilization review in any setting or successful… more
    Covenant Health (01/10/26)
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  • Mgr Comprehensive Care RN

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

    Molina Healthcare (Houston, TX)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... At least 2 years clinical nursing experience, including at least 1 year of utilization review , medical claims review , long-term services and supports (LTSS),… more
    Molina Healthcare (01/09/26)
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  • Utilization Management Appeals Nurse

    Humana (Austin, TX)
    …MRM, SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the (appropriate state) with no disciplinary ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The… more
    Humana (01/18/26)
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  • RN Clinical Manager, Home Health

    CenterWell (Austin, TX)
    …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case ...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Background… more
    CenterWell (01/16/26)
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  • RN Clinical Manager, Home Health

    CenterWell (San Angelo, TX)
    …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (01/03/26)
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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 ... case management **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse -...and federal programs + Comprehensive knowledge of discharge planning, utilization management, case management, performance improvement and… more
    Houston Methodist (01/16/26)
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  • Case Manager

    Houston Methodist (The Woodlands, TX)
    …1pm - 9pm. At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case ... experience + Case management experience preferred **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse - Texas State Licensure - Texas… more
    Houston Methodist (01/16/26)
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