• PharmaCord (Austin, TX)
    …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... never send a check (electronic or physical) to purchase home office equipment. If you receive any suspicious communication...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… more
    Upward (08/01/25)
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  • Utilization Management Nurse

    Humana (Austin, TX)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (10/18/25)
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  • SNF Utilization Management RN…

    Humana (Austin, TX)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
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  • Registered Nurse Case Management

    HCA Healthcare (Austin, TX)
    …Austin Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse Case Management you can be a part of change. **Benefits** St. David's ... positive outcomes for your patients as a (an) Registered Nurse Case Management . We want your knowledge...supporting a balance of optimal care and appropriate resource utilization . + You will provide case management more
    HCA Healthcare (10/14/25)
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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 ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
    Sharecare (10/22/25)
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  • Field Nurse Practitioner (Boise, ID)

    Molina Healthcare (Austin, TX)
    …receptive including home , nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and provide ... 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a home health,...home health as a licensed clinician, especially in management of chronic conditions + Experience with underserved populations… more
    Molina Healthcare (10/16/25)
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  • Field Nurse Practitioner (Pocatello, ID)

    Molina Healthcare (Austin, TX)
    …(EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, community health or public health ... in home health as a licensed clinician, especially in management of chronic conditions. * Experience with underserved populations facing socioeconomic barriers… more
    Molina Healthcare (10/17/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Austin, TX)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (10/15/25)
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  • Registered Nurse Case Manager PRN

    HCA Healthcare (Round Rock, TX)
    …us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** St. David's Round Rock ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
    HCA Healthcare (09/21/25)
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  • Appeals Nurse

    Humana (Austin, TX)
    …Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review/Quality Management experience + Experience working with MCG ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals...Friday; 8:00 am-5 pm Eastern Standard Time **Work at Home Requirements** To ensure Hybrid Office/ Home associates'… more
    Humana (10/23/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Round Rock, TX)
    **Description** **Introduction** Do you have the career opportunities as a Registered Nurse Case Manager you want in your current role? We invest in what matters ... most to nurses like you - at home , at work, and at every stage in your...Rock Medical Center! **Job Summary and Qualifications** **The Registered Nurse (RN) CM is responsible for promoting patient-centered care… more
    HCA Healthcare (10/14/25)
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  • Clinical Reviewer, Nurse -9am -6pm PST

    Evolent (Austin, TX)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
    Evolent (10/21/25)
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  • Consultant, Nurse Disability I

    Lincoln Financial (Austin, TX)
    …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at ...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position… more
    Lincoln Financial (10/10/25)
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  • Operating Room Nurse

    HCA Healthcare (Austin, TX)
    …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse position and spend more time at the bedside with the patient. ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
    HCA Healthcare (09/17/25)
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  • Appeals Nurse

    Evolent (Austin, TX)
    …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
    Evolent (10/11/25)
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  • Clinical Manager Home Health

    CenterWell (Austin, TX)
    …+ Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment. **Scheduled Weekly ... patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission… more
    CenterWell (09/06/25)
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  • Medical Director

    Molina Healthcare (Austin, TX)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (10/22/25)
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  • Medical Director (AZ)

    Molina Healthcare (Austin, TX)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (10/17/25)
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  • Bone Marrow Transplant Coordinator

    HCA Healthcare (Austin, TX)
    Nurse in transplant services + Minimum 3 years' experience in Case Management / Utilization Education + Graduate of an accredited school of nursing, BSN ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
    HCA Healthcare (10/03/25)
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