- Molina Healthcare (Dallas, TX)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. + ... of payment decisions. + Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. + Provides training and… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Nurse Scientist position is responsible for leading the development, coordination, implementation, evaluation, and dissemination of nursing ... research activities. This position works closely with the Director and Manager for Nursing Science to strategically plan, and outline priority initiatives based on… more
- Elevance Health (Grand Prairie, TX)
- ** Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the exception of ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Senior** will be responsible for identifying, monitoring, and… more
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Fresenius Medical Center (Austin, TX)
- …care pre, during and post procedure, under the direction of the Facility Manager , Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing ... and physical structure of the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment in the vascular access… more
- CenterWell (Amarillo, TX)
- …**This position comes with a $10K sign-on bonus.** + The **Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more
- Houston Methodist (The Woodlands, TX)
- …Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on ... initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from the physician… more
- Texas Health Resources (Dallas, TX)
- Case Manager - Inpatient Rehabilitation _Bring your passion to Texas Health So We Are Better + Together_ **Work location:** Texas Health Dallas, 8200 Walnut Hill Ln, ... case management experience is preferred. * RN - Registered Nurse Upon Hire Req or LMSW - Licensed Master...Management 12 Months Req or ACM - Accredited Case Manager upon hire if LBSW/LMSW 12 Months Req or… more
- Amgen (Houston, TX)
- …awareness and product information to support optimal patient care. As an Account Manager , you will drive product utilization while identifying and addressing the ... role is accepting applications for future openings starting January 2026**_** **Account Manager ** **Live** **What you will do** Let's do this. Let's change the… more
- HCA Healthcare (Austin, TX)
- …David's Employee Health and Safety Program for external employers, and serves as Case Manager and Registered Nurse for Occupational Health Services. + You will ... Our St. David's Healthcare team is looking for a(an) Employee Health Nursing Manager . HCA Healthcare is an advanced healthcare network that has committed up to… more