• Utilization Management Nurse

    CVS Health (Austin, TX)
    …6:00 pm EST or 9:30am to 6:00pm EST with occasional weekend/holiday/evening rotation.** ** Utilization Management is a 24/7 operation and work schedules will ... with heart, each and every day. Medicare Clinical Predetermination Nurse **Must be willing and able to work Monday...or 9:30am to 6:00pm eastern with occasional weekend/holiday/evening rotation. Utilization Management is a 24/7 operation and… more
    CVS Health (08/15/25)
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  • SNF Utilization Management RN…

    Humana (Austin, TX)
    …help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
    Humana (08/09/25)
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  • Lead Utilization Management

    Houston Behavioral Healthcare Hospital (Houston, TX)
    …Healthcare Hospital (HBHH) currently has an opening for Full-time Lead Utilization Management Coordinator, Monday-Friday, 8a-4p. The Lead Utilization ... Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients… more
    Houston Behavioral Healthcare Hospital (08/09/25)
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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 ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… 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 ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
    CenterWell (08/02/25)
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  • Utilization Management

    Elevance Health (Grand Prairie, TX)
    ** Utilization Management Representative I** **Location:** This role enables associates to work virtually full-time, with the exception of required in person ... **Hours:** Monday - Friday, 8am - 5pm PST The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
    Elevance Health (08/15/25)
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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...nursing experience, which includes two years in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN -… 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 ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance… more
    Houston Methodist (07/29/25)
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  • NICU | Utilization Management

    CVS Health (Austin, TX)
    …all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit ... solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other… more
    CVS Health (08/13/25)
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  • Behavioral Health Utilization Review RN MSW

    HCA Healthcare (Pasadena, TX)
    nursing or behavioral health experience required + 1-3 years relevant case management / utilization review experience preferred + Must hold and maintain ... integrity. We care like family! Jump-start your career as a Behavioral Health Utilization Review RN MSW today with Parallon. **Benefits** Parallon offers a total… more
    HCA Healthcare (08/14/25)
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