• 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 and ... **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (05/20/25)
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  • Utilization Review Clinician…

    Centene Corporation (Austin, TX)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... on workplace flexibility. **Hours: 9:30am-6:00pm Pacific Standard Time Zone; Monday -Friday.** **Must have an active, unrestricted California or Texas state… more
    Centene Corporation (07/10/25)
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  • Concurrent Review Nurse

    Actalent (Dallas, TX)
    Job Title: Review Nurse Job Description The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical necessity for ... various procedures and processes to complete authorizations successfully. The nurse will collaborate with a team of nurses and...Skills + Experience in utilization management, concurrent review , prior authorization, utilization review ,… more
    Actalent (07/03/25)
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  • Disease Management Nurse - Remote

    Sharecare (Austin, TX)
    utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
    Sharecare (07/12/25)
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  • Nurse Manger - PCU - M2W

    Texas Health Resources (Dallas, TX)
    ** Nurse Manager - PCU** _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like you to ... Health family._ + Work location: Texas Health Dallas + Core work hours: Monday - Friday; 8:00a-5:00p Texas Health Presbyterian Hospital Dallas has advanced health… more
    Texas Health Resources (07/10/25)
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  • Nurse Manager I-Surgery

    Texas Health Resources (Bedford, TX)
    ** Nurse Manager I-Surgery** _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like ... location: Texas Health Harris Methodist HEB, Bedford, TX + Core work hours: Monday -Friday 8:00a-5:00p **Texas Health HEB** Since 1973, Texas Health HEB has been a… more
    Texas Health Resources (07/12/25)
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  • Nurse Manager - CV ICU

    Texas Health Resources (Dallas, TX)
    ** Nurse Manager - CV ICU** _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like you ... family._ + Work location: Texas Health Dallas + Core work hours: Monday -Friday 8:00a-5:00p For more than a half-century, Texas Health Presbyterian Hospital Dallas… more
    Texas Health Resources (04/24/25)
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  • 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 (07/10/25)
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  • Clinical Nurse , Outpatient - GI Radiation…

    MD Anderson Cancer Center (Houston, TX)
    *Clinical Nurse - Thoracic Radiation Oncology* *Location:* The University of Texas MD Anderson Cancer Center - Houston, TX *Shift:* Monday - Friday, 8:00 AM - ... team in the Department of Thoracic Radiation Oncology. The Clinical Nurse manages patient outcomes by providing, coordinating, and supporting the clinical… more
    MD Anderson Cancer Center (07/08/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Grand Prairie, TX)
    **Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... accommodation is granted as required by law._** **"** **Hours: Monday - Friday 9:00am to 5:30pm with 2 late...hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management… more
    Elevance Health (07/12/25)
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  • RN Wound Care Nurse Navigator

    AdventHealth (Burleson, TX)
    …Health Resources and AdventHealth.** **Schedule:** **Full-Time** **Shift** : **Days - Monday - Friday (8:00am - 5:00pm)** **Location:** 11801 South Fwy., Burleson, ... winning facility and departments including "Great Place to Work" by Becker's Hospital Review and Gallup. + Work with the latest technology and top experts including… more
    AdventHealth (06/13/25)
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  • Supervisor, Care Review (RN)

    Molina Healthcare (San Antonio, TX)
    …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management ... For this position we are seeking a (RN) Registered Nurse who be licensed in the state they reside....are looking for a RN Supervisor to manage a utilization management team supporting 14 Marketplace plans. Home office… more
    Molina Healthcare (07/09/25)
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  • Occupational Health RN PRN - Temporary Flu…

    Houston Methodist (Houston, TX)
    …PRN, non-benefit eligible position that will work UP TO 40 hours per week Monday - Friday (Late August through late November)** + **Vaccination clinic hours will be ... Enterprise Health and Epic.** At Houston Methodist, the Occupational Health Nurse PRN position provides expert, integrated, cost-effective, quality patient care… more
    Houston Methodist (07/12/25)
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  • Radiology RN PRN

    AdventHealth (Mansfield, TX)
    …PRN **Shift** : Expected shifts are exam based but typical hours run 730a-4pm Monday - Friday No CALL **Location:** 2300 Lone Star Road; Mansfield, TX 76063 **The ... career with AdventHealth, named in 2018 by Becker's Hospital Review as one of the "150 Top Places to...patient populations across the continuum of illness; promotes effective utilization of and monitors health care resources; and provides… more
    AdventHealth (06/27/25)
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  • RN Care Manager

    AdventHealth (Killeen, TX)
    …understanding that **together** we are even better. **Schedule:** Full-Time **Shift** : ** Monday - Friday 8:00am - 4:00pm w/ alternating weekends & holidays (every ... physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge...(as permitted by the patient) as well as a review of the current and past inpatient and outpatient… more
    AdventHealth (07/11/25)
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  • Category Manager

    System One (Houston, TX)
    …Pay rate up to $60/hr. Salary will be commensurate with experience. + Work schedule: Monday - Friday: 7:00am - 4:00pm or 8:00am - 5:00pm (Subject to Change) + Weekly ... Build out effective Category Strategies by performing analysis on internal utilization , external benchmarking, identify optimized cost models, and develop an… more
    System One (07/03/25)
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  • RN Discharge Lounge

    AdventHealth (Burleson, TX)
    …Texas Health Resources and AdventHealth.** **Schedule:** **Full-Time** **Shift** : ** Monday Friday (11:00am 7:30pm)** **Location:** 11801 South Fwy., Burleson, TX ... winning facility and departments including Great Place to Work by Beckers Hospital Review and Gallup. + Work with the latest technology and top experts including… more
    AdventHealth (07/11/25)
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  • Clinical Rehabilitation Specialist

    HCA Healthcare (Dallas, TX)
    …City Healthcare** **Clinical Rehabilitation Specialist** **Full Time Weekends** **Friday- Monday ** **4/ 10 hour shifts** **Introduction** Are you passionate about ... rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong clinical evidence to… more
    HCA Healthcare (06/21/25)
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  • Manager of Comprehensive Care RN

    Baylor Scott & White Health (Waco, TX)
    …issues tied to patient care coordination, discharge planning, case management, and utilization review . + Monitor procedures and systems closely for efficient ... Health Hillcrest Medical Center** **Setting: Case Management** **Schedule: Full Time - Monday -Friday 8am-5pm** Here at Baylor Scott & White Health we promote the… more
    Baylor Scott & White Health (06/07/25)
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  • Physician - Geriatrics Hospital In Home EDRP…

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Responsibilities The Geriatric and Extended Care Medical ... up for other GEC providers. - Participates in chart reviews, peer review and other process improvement initiatives. The staff will complete training requirements,… more
    Veterans Affairs, Veterans Health Administration (05/01/25)
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