• Utilization Management Nurse

    CVS Health (Austin, TX)
    …all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
    CVS Health (08/28/25)
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  • SNF Utilization Management RN…

    Humana (Austin, TX)
    …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
    Humana (08/09/25)
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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...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 RN - Hybrid

    Baylor Scott & White Health (Dallas, TX)
    …to fit their needs. + Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. ... issues or trends impacting specific entities to the appropriate management is expected. + Part of your work will...is required. + You must hold a valid Registered Nurse License (RN). As a health care system committed… more
    Baylor Scott & White Health (08/29/25)
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  • Sr Utiliz. Review Spclst Nurse

    Houston Methodist (Houston, TX)
    …the leadership team for special project activities related but not limited to, throughput, utilization review and utilization management to align with the ... At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position...members. + Serves as the primary information resource for utilization management staff, payers, physicians, and other… more
    Houston Methodist (08/26/25)
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  • Registered Nurse (RN) - Case Manager - PRN

    Texas Health Resources (Arlington, TX)
    …providers and other hospital personnel in understanding payor plans, resolving utilization management issues and assigning appropriate patient classification as ... Registered Nurse (RN) - Case Manager - PRN Work...1. Maintains a current knowledge of regulatory requirements for utilization management including but not limited to… more
    Texas Health Resources (08/29/25)
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  • Disease Management Nurse - Remote

    Sharecare (Austin, TX)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (08/13/25)
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  • Registered Nurse RN Case Management

    HCA Healthcare (Webster, TX)
    …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse RN Case Management to join our healthcare family. **Benefits** HCA Houston ... - and empowers their passion for patient care. Apply today for our Registered Nurse RN Case Management opportunity. **Job Summary and Qualifications** We are… more
    HCA Healthcare (08/22/25)
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  • Transfer Center Point of Entry Nurse - Mid…

    Houston Methodist (Houston, TX)
    …hospital units through the facilitation and coordination of patient flow and bed utilization . The POE Nurse position collaborates with clinical staff and ... At Houston Methodist, the Point of Entry Nurse (POE) is a licensed registered nurse...interprofessional health care team to ensure resource utilization is appropriate to the patient's clinical needs and… more
    Houston Methodist (07/21/25)
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  • Registered Nurse - Women's Veteran Program…

    Veterans Affairs, Veterans Health Administration (El Paso, TX)
    …BSN At least three years of experience as a full-time Registered Nurse VA Experience Supervisory/ Management experience Grade Determinations: The following Scope, ... Summary The Registered Nurse - Women's Veteran Program Manager provides care and counseling of persons or the promotion and maintenance of health and prevention of… more
    Veterans Affairs, Veterans Health Administration (08/28/25)
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