• RN Medicare Compliance…

    Sedgwick (Austin, TX)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance RN Medicare Compliance - Proactive Reduction Outreach **PRIMARY PURPOSE** ... review, and analysis and interpretation of interventions for the preparation of Medicare Set-Aside allocations. **ARE YOU AN IDEAL CANDIDATE?** We are looking for… more
    Sedgwick (11/12/25)
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  • Field Care Manager, Registered Nurse…

    CVS Health (Austin, TX)
    …clinical tools and information/data. - Utilizes case management processes in compliance with regulatory and company policies and procedures. - Facilitates ... optimal function or return to work. - Develops a proactive course of action to address issues presented to...CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. - 2 years Case Manager (CM), discharge… more
    CVS Health (11/04/25)
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  • Director of Case Management & Social Services…

    Houston Methodist (The Woodlands, TX)
    …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... At Houston Methodist, the Director Case Management & Social Services RN position is responsible for strategy, function and operations of the Case Management & Social… more
    Houston Methodist (11/12/25)
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  • Home Health Quality Assurance Auditor

    Humana (Corpus Christi, TX)
    …process management as needed. Requires applicable State licensure in field of study: Registered Nurse ( RN ), Licensed Masters Clinical Social Worker (LCSW), ... 1 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 1 work assignments… more
    Humana (10/01/25)
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  • Clinical UM Nurse

    CenterWell (Austin, TX)
    …**Use your skills to make an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license ( RN ) with no disciplinary action and ... and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent...a related field + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage… more
    CenterWell (11/12/25)
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