• Utilization Management Nurse…

    CVS Health (Austin, TX)
    …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in CT zones **Education**… more
    CVS Health (08/08/25)
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  • Utilization Management Nurse…

    CVS Health (Austin, TX)
    …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... compassionate. And we do it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
    CVS Health (07/30/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
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  • Utilization Management

    Humana (Austin, TX)
    …health first** The UM Administration Coordinator 2 contributes to administration of utilization management . The UM Administration Coordinator 2 performs basic ... service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
    Humana (08/08/25)
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  • Utilization Management Coordinator

    Ascension Health (Georgetown, TX)
    …+ 1-2 years of Health Plan experience, preferred. + 1-2 years of Utilization Management experience, preferred. + High call phone volume experience, preferred. ... CST, Partially Remote, occasional weekends. + **Facility:** Ascension Care Management Insurance + **Location:** Seton Administrative Offices, 1345 Philomena, Austin,… more
    Ascension Health (08/08/25)
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  • Utilization Management Clinical…

    CVS Health (Austin, TX)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (07/31/25)
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  • Utilization Review Nurse - Case…

    Houston Methodist (The Woodlands, TX)
    …eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and managed ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a...determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the plan… more
    Houston Methodist (07/12/25)
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  • Utilization Review Specialist RN - FT Days

    Houston Methodist (Sugar Land, TX)
    …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... eligibility for state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance improvement, and managed… more
    Houston Methodist (07/29/25)
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  • Utilization Management Senior…

    Molina Healthcare (San Antonio, TX)
    **Knowledge/Skills/Abilities** + Perform research and analysis of complex healthcare utilization and performance date, claims data, pharmacy data, and lab data ... regarding utilization and cost containment information. + Evaluate, write, and...cost containment information. + Evaluate, write, and present healthcare utilization and cost containment reports and makes recommendations based… more
    Molina Healthcare (08/02/25)
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