• Utilization Review Nurse

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (05/15/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager ( RN ) - Full Time…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case management, which includes ... clinical experience + Case management experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or… more
    Houston Methodist (05/16/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Inpatient…

    Molina Healthcare (Houston, TX)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
    Molina Healthcare (05/24/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, PA ( RN )…

    Molina Healthcare (Houston, 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 (03/07/25)
    - Save Job - Related Jobs - Block Source
  • Community Care Nurse , HCT ( RN )

    ChenMed (Houston, TX)
    RN with Bachelor Degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
    ChenMed (03/28/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Houston, TX)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
    Molina Healthcare (05/16/25)
    - Save Job - Related Jobs - Block Source
  • Director - Case Management & Social Services…

    Houston Methodist (Houston, TX)
    …HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of...Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
    Houston Methodist (05/02/25)
    - Save Job - Related Jobs - Block Source
  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Humble, TX)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (05/07/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …and personal growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review all applications. Highly qualified ... We care like family! Jump-start your career as a(an) Registered Nurse Case Manager today with HCA...preferred + Current Texas licensure with State Board of Nurse Examiners as an RN + 1+… more
    HCA Healthcare (05/04/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Quality Coordinator

    HCA Healthcare (Houston, TX)
    …Hospital we support our colleagues in their positions. Join our Team as a(an) Registered Nurse Quality Coordinator and access programs to assist with every stage ... and more affordable to gain certifications and job skills. Apply today for our Registered Nurse Quality Coordinator opening and continue to learn! **Job Summary… more
    HCA Healthcare (05/24/25)
    - Save Job - Related Jobs - Block Source
  • Operating Room Registered Nurse

    HCA Healthcare (Houston, TX)
    …you want to join an organization that invests in you as an Operating Room Registered Nurse ? At North Cypress Surgery Center, you come first. HCA Healthcare has ... difference. We are looking for a dedicated Operating Room Registered Nurse like you to be a...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
    HCA Healthcare (04/20/25)
    - Save Job - Related Jobs - Block Source
  • Investigator, SIU RN -Remote

    Molina Healthcare (Houston, TX)
    …abuse through the identification of aberrant coding and/or billing patterns through utilization review . * Incorporate leadership and communication skills to work ... care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED… more
    Molina Healthcare (04/11/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Nurse , Outpatient (Pacemaker)…

    MD Anderson Cancer Center (Houston, TX)
    …or treatment team concerning home care, potential problems, emotional concerns or utilization review status. Participates in regularly scheduled team conferences ... operations. Remains abreast of developments in the field of nursing or utilization review by attending seminars and workshops, communicating with peers,… more
    MD Anderson Cancer Center (03/18/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Specialist

    Houston Methodist (Houston, TX)
    …- One year of clinical experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact ... an acute care hospital setting is required; coding and utilization review experience preferred + For Medical...State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
    Houston Methodist (05/01/25)
    - Save Job - Related Jobs - Block Source
  • Transfusion Safety Officer - FT/Days

    Houston Methodist (Houston, TX)
    …preferred + Experience in performance improvement preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... Management Performance Improvement (CMPI) committee. + Contributes to blood utilization review process by performing transfusion audits....Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
    Houston Methodist (04/18/25)
    - Save Job - Related Jobs - Block Source
  • Assistant Director of Nursing

    Erickson Living (Houston, TX)
    …and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) ... and survey readiness. What you will need + Current RN nursing license with no restrictions for the state...3 years' experience in a healthcare leadership role (Charge Nurse , Unit Manager, etc.). + Experience with an electronic… more
    Erickson Living (05/13/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager ( RN ) - PRN

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a target ... department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (05/14/25)
    - Save Job - Related Jobs - Block Source
  • Certified Case Manager/ RN - Willowbrook

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse ( RN ) responsible for comprehensively planning for case management of a ... includes two years in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + Health Services\ RN - Registered Nurse - Texas State Licensure and/or… more
    Houston Methodist (05/09/25)
    - Save Job - Related Jobs - Block Source
  • Occupational Health RN Full-Time (Days)

    Houston Methodist (Houston, TX)
    …+ Occupational health nursing experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... as appropriate. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Conducts initial management, review and monitoring of all occupational injuries and illnesses....Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
    Houston Methodist (05/07/25)
    - Save Job - Related Jobs - Block Source
  • Transplant Coordinator RN

    Catholic Health Initiatives (Houston, TX)
    …**Qualifications** **Education and Licensure** **Required:** + Bachelor's Degree - Nursing + Registered Nurse ( RN ) **Minimum Experience** **Required:** + ... **Responsibilities** The Transplant Coodinator RN provides coordination of all aspects of the transplant service in order to maintain an organized and efficient… more
    Catholic Health Initiatives (05/17/25)
    - Save Job - Related Jobs - Block Source