• Utilization Management Nurse

    CVS Health (Austin, TX)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse

    CVS Health (Austin, TX)
    …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... compassionate. And we do it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
    CVS Health (07/30/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
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  • Utilization Review Nurse - Case…

    Houston Methodist (The Woodlands, TX)
    …eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and managed ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position...determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the plan… more
    Houston Methodist (07/12/25)
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  • Clinical UM Nurse 2

    CenterWell (Austin, TX)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
    CenterWell (08/01/25)
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  • Utilization Review Specialist RN - FT Days

    Houston Methodist (Sugar Land, TX)
    …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance… more
    Houston Methodist (07/29/25)
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  • Utilization Management Clinical…

    CVS Health (Austin, TX)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (07/31/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (San Antonio, TX)
    …review care services related to mental health and substance abuse is preferred. + Utilization Review/ Utilization management with behavioral health cases + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (07/31/25)
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  • Disease Management Nurse - Remote

    Sharecare (Austin, TX)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (07/12/25)
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  • Nurse Manager of Case Management

    HCA Healthcare (Frisco, TX)
    …sites of care in 21 states and the United Kingdom. We are looking for a Nurse Manager of Case Management for our Medical City Frisco team where excellence ... to be an influencer in healthcare? **Apply for our Nurse Manager of Case Management role today!**...projects. + Works cooperatively with physicians to achieve the utilization of the case management plan. +… more
    HCA Healthcare (07/14/25)
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