• UM Behavioral Health

    Humana (Austin, TX)
    …our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the ... health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and… more
    Humana (09/09/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Austin, TX)
    …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): + ... each and every day. **Position Summary** This Utilization Management ( UM ) Nurse Consultant role is 100% remote...accepting applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years'… more
    CVS Health (09/10/25)
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  • Care Review Clinician, Prior Auth (RN) Pega Float…

    Molina Healthcare (Houston, TX)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... this position we are hiring for a float team to support PEGA UM systems throughout multiple states.** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services… more
    Molina Healthcare (07/12/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Houston, TX)
    …candidate will have experience with UM and prior authorization, within both Physical Health and Behavioral Health . Candidates with a Behavioral ... an integrated delivery of care across the continuum, including behavioral health and long-term care, for members...teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other… more
    Molina Healthcare (08/16/25)
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  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Dallas, TX)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... teams to promote Molina Care Model + Adheres to UM policies and procedures. **JOB QUALIFICATIONS** **Required Education** Any...field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required… more
    Molina Healthcare (08/31/25)
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  • PRN UR Coordinator

    San Antonio Behavioral Health (San Antonio, TX)
    …staff as needed. Essential Duties: + Collaborate and set standards with registered nurse (RN) case managers (CMs) and outcome managers to ensure that all ... indicated. + Identify and facilitate resolution of system process problems impeding UM functions. Identify and resolve delays and obstacles as appropriate. +… more
    San Antonio Behavioral Health (08/27/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (San Antonio, TX)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
    Molina Healthcare (08/31/25)
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