• Registered Nurse - Clinical…

    Cognizant (Austin, TX)
    …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
    Cognizant (10/09/25)
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  • Registered Nurse Case Manager IP…

    HCA Healthcare (Plano, TX)
    …of each individual is recognized. Submit your application for the opportunity below: Registered Nurse Case Manager IP RehabMedical City Plano **Benefits** Medical ... benefits may vary by location._** We are seeking a(an) Registered Nurse Case Manager IP Rehab for.... Prioritizes goals and develops a plan to achieve clinical and fiscal outcomes . Monitors various aspects of… more
    HCA Healthcare (10/21/25)
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  • RN Medical Claim Review Nurse Remote

    Molina Healthcare (San Antonio, TX)
    …and/or coding experience, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... resource for utilization management, chief medical officers, physicians and member/provider inquiries/ appeals . * Provides training and support to clinical peers.… more
    Molina Healthcare (10/19/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing clinical knowledge… more
    Molina Healthcare (09/06/25)
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  • Clinical Intake Coordinator…

    Select Medical (Dallas, TX)
    …and valid state licensure or eligibility for state licensure as a Registered Nurse , Physical Therapist, Occupational Therapist, or Speech Language Pathologist ... venture with Select Medical & Baylor Scott & White Health Dallas, TX ** Clinical Intake Coordinator / Clinical Liaison (RN strongly preferred)** **Full-Time,… more
    Select Medical (09/13/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …management or equivalent revenue cycle clinical role + Experience includes writing clinical appeals for medical necessity compliance or level of care for ... preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure --...care contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge… more
    Houston Methodist (10/29/25)
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  • Inpatient Auth Review Services RN or LPN -NICU

    HCA Healthcare (San Antonio, TX)
    …to join an organization that invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical Nurse -NICU (Code Pink)? At ... are looking for a dedicated Inpatient Authorization Review Services Registered Nurse or Licensed Practical Nurse...the account being denied by the payor that require clinical expertise. Communicates with third party payors to resolve… more
    HCA Healthcare (10/25/25)
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  • Denial Resource Center RN

    Baylor Scott & White Health (Dallas, TX)
    **JOB SUMMARY** The Denial Resource Center Registered Nurse (RN) is responsible for Baylor Scott & White Health denial management functions. The Denial Resource ... Associate's - EXPERIENCE - 2 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - Registered Nurse (RN) Hybrid expectation- On-site once a year Experience… more
    Baylor Scott & White Health (10/31/25)
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  • Senior Director Case Management

    Houston Methodist (Houston, TX)
    …or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure - Must ... and advancement of a unified case management model grounded in clinical excellence, throughput efficiency, care transitions, and denials prevention. A champion… more
    Houston Methodist (10/16/25)
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