• Utilization Review Nurse - Case…

    Houston Methodist (The Woodlands, TX)
    …plan of care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. **PEOPLE ... recognized guidelines. Manages assigned patients and communicates and collaborates with the case manager to assist with appropriate interventions to avoid denial… more
    Houston Methodist (07/12/25)
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  • Utilization Review Specialist RN - FT Days

    Houston Methodist (Sugar Land, TX)
    …the plan of care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. The ... for state, local, and federal programs + Comprehensive knowledge of utilization management, case management, performance improvement, and managed care… more
    Houston Methodist (07/29/25)
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  • Pharmacist, Utilization Management (UM)

    Molina Healthcare (Fort Worth, TX)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
    Molina Healthcare (07/27/25)
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  • Case Manager (RN) - PRN Days

    Houston Methodist (Sugar Land, 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 ... l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from… more
    Houston Methodist (05/25/25)
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  • Clinical Case Manager Behavioral…

    CVS Health (Arlington, TX)
    …compassionate. And we do it all with heart, each and every day. **Clinical Case Manager Behavioral Health** **Position Summary** This is a remote role, requiring ... Texas as well as the surrounding areas. The Clinical Case Manager utilizes advanced clinical judgment and...+ Bilingual. + Crisis intervention skills preferred. + Managed care/ utilization review experience preferred. + Case management… more
    CVS Health (08/01/25)
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  • Certified Case Manager

    Houston Methodist (Cypress, TX)
    At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a ... l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from… more
    Houston Methodist (07/26/25)
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  • Nurse Manager of Case Management

    HCA Healthcare (Frisco, TX)
    …of the department and organization. + Provides leadership for all areas of the Case Manager and Social Worker roles. + Audits Medicare Important Message from ... the United Kingdom. We are looking for a Nurse Manager of Case Management for our Medical...projects. + Works cooperatively with physicians to achieve the utilization of the case management plan. +… more
    HCA Healthcare (07/14/25)
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  • Case Manager RN

    HCA Healthcare (San Antonio, TX)
    …one year experience in utilization review, resource management, discharge planning or case management. Prior Case Manager experience in Acute setting is ... join an organization that invests in you as a(an) Case Manager RN? At Methodist Hospital Stone...and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of… more
    HCA Healthcare (06/21/25)
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  • RN Case Manager PRN

    HCA Healthcare (San Antonio, TX)
    …one year experience in utilization review, resource management, discharge planning or case management. Prior Case Manager experience in Acute setting is ... you have the PRN career opportunities as a(an) RN Case Manager PRN you want with your...and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of… more
    HCA Healthcare (06/21/25)
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  • Case Manager RN

    HCA Healthcare (San Antonio, TX)
    …one year experience in utilization review, resource management, discharge planning or case management. Prior Case Manager experience in Acute setting is ... of each individual is recognized. Submit your application for the opportunity below: Case Manager RNMethodist Hospital **Benefits** Methodist Hospital, offers a… more
    HCA Healthcare (06/21/25)
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