• Utilization Review Nurse…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (07/12/25)
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  • Registered Nurse - Utilization Management…

    Veterans Affairs, Veterans Health Administration (Houston, TX)
    …standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: 1-3 years Utilization Management, Nurse Case Manager ... development in practice with increased levels of self-direction. Uses Utilization Management criteria to perform basis review ...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
    Veterans Affairs, Veterans Health Administration (07/21/25)
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  • Manager - Case Management & Social…

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Manager Case Mgmt Social Svcs position is responsible for functional and operational aspects of the Case Mgmt./Social Work ... corporate and hospital administrators, medical staff, and defined customers related to the Case Mgmt. system. The Manager Case Mgmt./Social Work position… more
    Houston Methodist (07/24/25)
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  • Pharmacist, Utilization Management (UM)

    Molina Healthcare (Fort Worth, TX)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
    Molina Healthcare (07/27/25)
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  • Case Manager (RN) - PRN Days

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target ... l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from… more
    Houston Methodist (05/25/25)
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  • Certified Case Manager

    Houston Methodist (Cypress, TX)
    At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a ... l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from… more
    Houston Methodist (07/26/25)
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  • RN Case Manager PRN

    HCA Healthcare (San Antonio, TX)
    …of Science in Nursing + At least one year experience in utilization review , resource management, discharge planning or case management. Prior Case ... and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of...growth, we encourage you to apply for our RN Case Manager PRN opening. We review more
    HCA Healthcare (06/21/25)
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  • Case Manager RN

    HCA Healthcare (San Antonio, TX)
    …of Science in Nursing + At least one year experience in utilization review , resource management, discharge planning or case management. Prior Case ... and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of...encourage you to apply for our Case Manager RN opening. We promptly review all… more
    HCA Healthcare (06/21/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Pasadena, TX)
    …satisfaction and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly ... you have the career opportunities as a(an) Registered Nurse Case Manager you want with your current...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
    HCA Healthcare (06/26/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …satisfaction and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly ... like family! Jump-start your career as a(an) Registered Nurse Case Manager today with HCA Houston Healthcare...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
    HCA Healthcare (06/21/25)
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