• VP, Clinical Operations

    Molina Healthcare (Austin, TX)
    …State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality ... management initiatives and analytical studies aimed at optimizing utilization of medical resources and maximizing operational efficiencies. + Engages with… more
    Molina Healthcare (07/17/25)
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  • Manager Radiology Nurse Services

    CommonSpirit Health (Houston, TX)
    …to physicians, Radiology and nursing staff, business and financial services, utilization management and quality management ; Utilizes a scientific ... resource to staff members by providing coaching to all nursing staff. 6. Collaborates with the Radiology management...attainment of organizational goals as they pertain to the outcomes/ nurse manager role. 3. Analyzes the cost and quality… more
    CommonSpirit Health (08/10/25)
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  • Cluster Nurse Manager - Jester 3 Unit

    UTMB Health (Richmond, TX)
    …Develops and implements quality assurance/improvement programs at the facilities. + Implements utilization management programs at the facilities. + Assumes 24 ... Cluster Nurse Manager - Jester 3 Unit **Richmond, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2504302 The mission of… more
    UTMB Health (08/08/25)
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  • Registered Nurse III

    MTC (Raymondville, TX)
    …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... in our care. If you're looking for a rewarding nursing position where your skills can truly make a...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
    MTC (08/08/25)
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  • Cardiologist

    ChenMed (Houston, TX)
    …in conjunction with the transitional care team; hospital, SNF, post-acute, delegated utilization management and home-based services for the market. + Performs ... plan of care, providing health education, specialty referrals and case management referrals, providing follow-up care and applying clear, in-depth documentation… more
    ChenMed (07/04/25)
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  • Senior Risk & Compliance Analyst

    Highmark Health (Austin, TX)
    …Risk Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, ... and guidance to internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and Case Management (CM) processes and… more
    Highmark Health (07/04/25)
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  • Periop Nurse Coordinator - Neuro

    Houston Methodist (Houston, TX)
    …for employee engagement. **SERVICE ESSENTIAL FUNCTIONS** + Collaborates with anesthesia, OR charge nurse , and OR management to maximize efficiency and flow of ... At Houston Methodist, the Perioperative Nurse Coordinator position is an experienced Operating Room...timeframes, and respond accordingly. Provides input regarding OR block utilization and management . + Reviews the OR… more
    Houston Methodist (08/08/25)
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  • Case Manager PRN

    Select Medical (Frisco, TX)
    …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... of the discharge planning process. **The primary job functions in Case Management include:** + Clinical Interventions/Discharge and Care Planning Management +… more
    Select Medical (08/08/25)
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  • Lead Social Worker

    HCA Healthcare (Webster, TX)
    …Social Work Services with experience in health care delivery systems with focus on Utilization Management & Case Management . experience Required Years of ... effective communication of activities with emphasis on coordination of resource management activities. Coordinates discharge planning meetings with nursing and… more
    HCA Healthcare (07/30/25)
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  • LVN Care Review Clinician, Prior Authorization

    Molina Healthcare (TX)
    …only). **Preferred Experience** 3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, ... Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT LICENSURE required.** **Individual state… more
    Molina Healthcare (08/15/25)
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