• Healthcare Clinical Documentation Specialist

    Deloitte (Dallas, TX)
    …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN , Quality, DRG Validation and… more
    Deloitte (11/21/25)
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  • Case Manager Austin Market Float Pool

    HCA Healthcare (Austin, TX)
    …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...required experience: Minimum of at least two years of RN experience.** **EDUCATION REQUIRED** + **Associate's Degree-Major: Nursing** +… more
    HCA Healthcare (09/19/25)
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  • Case Manager Austin Market Float Pool

    HCA Healthcare (Austin, TX)
    …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...required experience: Minimum of at least two years of RN experience.** **EDUCATION REQUIRED** + **Associate's Degree-Major: Nursing** +… more
    HCA Healthcare (08/28/25)
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  • Branch Director - Hospice

    Elara Caring (Conroe, TX)
    …Identifies and reports potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development ... Key Accounts, including participation in weekly, monthly, and quarterly review meetings, as needed. + Ensures accuracy of all...**What is Required?** + 5+ years Hospice experience + RN license in state of operations that is current… more
    Elara Caring (10/28/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (San Antonio, TX)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Austin, TX)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...member care. The candidate must have Medicare Appeals and/or Utilization Management knowledge. Work hours are Monday-Friday 8:00am- 5:00pm… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Houston, TX)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
    Molina Healthcare (11/21/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
    CenterWell (11/22/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
    CenterWell (11/13/25)
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  • RN Case Manager

    HCA Healthcare (Lewisville, TX)
    …preferences and needs are considered and aligned What qualifications you will need: + Registered Nurse with current TX state license required + Associate Degree ... supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +...career path, we encourage you to apply for our RN Case Manager opening. We review all… more
    HCA Healthcare (11/22/25)
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