• Utilization Review Clinician…

    Centene Corporation (San Antonio, TX)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... BHEC if you hold a LPC, LCSW, or LMFT. Registered Nurse can hold Texas State Licensure...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more
    Centene Corporation (05/10/25)
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  • RN - Utilization Review

    Ascension Health (Austin, TX)
    **Details** + **Department:** Utilization Review + **Schedule:** PRN Day shift + **Location:** Remote - Must live within 60 miles of Texas Administrative Offices ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… more
    Ascension Health (05/14/25)
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  • Utilization Review Nurse

    Adecco US, Inc. (Houston, TX)
    Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This role is in person / on site. Please read below ... 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . **...* Bachelors' degree in nursing preferred * Current, unrestricted RN License in Texas . 2 to 3 years… more
    Adecco US, Inc. (05/01/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Houston, TX)
    …be required to perform other duties as assigned. **Qualifications** **Required:** -Associate's Degree - Registered Nurse ( RN ) -Two (2) years of experience ... -Knowledge of case management, working of Medicare, Medicaid and private insurance -Ability to interact professionally with case management staff, physicians and payers + If offered the position, you will have 90 days to pass the MCG competency test. However,… more
    Catholic Health Initiatives (05/11/25)
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  • Care Review Clinician, PA ( RN )…

    Molina Healthcare (Austin, TX)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
    Molina Healthcare (04/11/25)
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  • Care Review Clinician, Inpatient…

    Molina Healthcare (San Antonio, TX)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... care/medical experience. R **equired License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. MULTI… more
    Molina Healthcare (05/09/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Austin, TX)
    …your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...Manager with OASIS and Coding certification to work remotely. RN , PT, OT, and SLP's with certifications will be… more
    BAYADA Home Health Care (04/02/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Austin, TX)
    …in your career path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Case Manager you want in...license Preferred: + Certification in case management, nursing, or utilization review preferred. St. David's North Austin… more
    HCA Healthcare (05/07/25)
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  • Program Mgr UR/Case Management - CMC - Clear Lake…

    UTMB Health (Friendswood, TX)
    …from an accredited school of Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum of five (5) years full-time wage ... quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical...earning experience as a professional nurse in a healthcare setting with at least two… more
    UTMB Health (04/04/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Austin, TX)
    …care. - Perform medical necessity reviews. **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. - A Registered Nurse that holds an active, unrestricted...lower levels of care. - 1+ years' experience in Utilization Review . - CCM and/or other URAC… more
    CVS Health (05/15/25)
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