• RN UM Care Review

    Molina Healthcare (TX)
    JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for ... care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/09/25)
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  • Care Coordinator UM /CM I

    Health Care Service Corporation (Richardson, TX)
    …health needs within the scope of their benefit plan. **Required Job Qualifications:** + Registered Nurse ( RN ) with current, valid, unrestricted license to ... **Job Summary** This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing discharge planning… more
    Health Care Service Corporation (11/08/25)
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  • Nurse Practitioner, Behavioral Health…

    Molina Healthcare (Dallas, TX)
    …Minimum 3 years of experience as a Registered Nurse and/or Nurse Practitioner, ideally in managed care , behavioral health, or utilization management. + ... with physicians to ensure clinically appropriate, cost-effective, and regulatory-compliant care determinations. Assists in evaluating medical necessity, ensuring timeliness,… more
    Molina Healthcare (11/08/25)
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  • Care Review Clinician ( RN

    Molina Healthcare (Dallas, TX)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Fully remote opportunity for a TX licensed RN with Utilization Management experience to join our Prior...* Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM more
    Molina Healthcare (10/29/25)
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  • RN Care Review Clinician…

    Molina Healthcare (Fort Worth, TX)
    JOB DESCRIPTION Job Summary The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible for ... care . We are seeking a candidate with a RN licensure that has previous UM and...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/04/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Austin, 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 ... * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/01/25)
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  • Inpatient Auth Review Services RN

    HCA Healthcare (San Antonio, TX)
    …Do you want to join an organization that invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical Nurse -NICU ... difference. We are looking for a dedicated Inpatient Authorization Review Services Registered Nurse or... contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the… more
    HCA Healthcare (11/01/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Fort Worth, TX)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM...unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization… more
    Molina Healthcare (11/12/25)
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  • Care Review Clinician, PA…

    Molina Healthcare (Fort Worth, TX)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional… more
    Molina Healthcare (10/26/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (TX)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and… more
    Molina Healthcare (11/09/25)
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