• Registered Nurse Case Manager PRN

    HCA Healthcare (Dallas, TX)
    …outcomes, or work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Medical City ... supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +...Makes appropriate referrals to third party payer, disease and case management programs for recurring patients and… more
    HCA Healthcare (07/14/25)
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  • Physician Advisor

    Houston Methodist (The Woodlands, TX)
    …of current state, federal, and CMS regulations, DNV requirements, and guidelines on case management , utilization review, and clinical documentation. + ... Advisor position is responsible for teaching, consulting, and advising the case management department, clinical documentation specialists, medical staff and… more
    Houston Methodist (07/05/25)
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  • Care Coordinator - Weight Management

    Houston Methodist (Houston, TX)
    …could include physician's office, acute care, long term care, home health. + Case Management experience preferred. **LICENSES AND CERTIFICATIONS - REQUIRED** + ... management support to the department staff to facilitate efficient utilization of resources including referrals management , communication and collaboration… more
    Houston Methodist (07/29/25)
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  • Senior Customer Success Specialist | HealthTech…

    Wolters Kluwer (Dallas, TX)
    …efforts, prioritizing efforts and resources for assigned customer portfolio. + Ongoing Utilization Management + Oversee and analyze customer utilization ... to set utilization goals and benchmark success, leveraging tools (reports, case studies, client references, etc.) to win and maintain customer support + Manage… more
    Wolters Kluwer (07/18/25)
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  • Transfer Center Point of Entry Nurse - Mid Shift

    Houston Methodist (Houston, TX)
    …units through the facilitation and coordination of patient flow and bed utilization . The POE Nurse position collaborates with clinical staff and interprofessional ... health care team to ensure resource utilization is appropriate to the patient's clinical needs and within covered benefits. This position ensures a compassionate,… more
    Houston Methodist (07/21/25)
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  • Medical Director - Florida

    Humana (Austin, TX)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/29/25)
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  • Medical Director - South Carolina SE Region

    Humana (Austin, TX)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/22/25)
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  • Medical Director - Mid West Region

    Humana (Austin, TX)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (05/14/25)
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  • Medical Director - NorthEast Region

    Humana (Austin, TX)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (07/25/25)
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  • Assistant Vice President

    Sedgwick (Austin, TX)
    …and client satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for ... multiple business lines; and to provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction… more
    Sedgwick (06/29/25)
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