• HealthCare Support (Houston, TX)
    Utilization Review RN HealthCare Support is...in Remote Houston TX . Daily Responsibilities for Utilization Review RN : WIll need to ... actively seeking a Utilization Review RN to fill an opening with a Prestigious HealthCare Company… more
    Upward (08/09/25)
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  • Utilization Review Nurse

    Actalent (Houston, TX)
    Immediate Hiring for " Remote Clinical Review RN " Job Description: + Perform concurrent reviews to assess member's overall health. + Review the type of ... Utilization Management Experience is Mandatory + Active Compact RN License is Mandatory If you are Interested ,...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
    Actalent (10/31/25)
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  • RN Lead, DRG Coding/Validation…

    Molina Healthcare (Houston, TX)
    …claims review , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary The RN Lead, DRG Coding/Validation provides lead level support...experience. Work hours are: Monday- Friday 8:00am - 5:00pm Remote position Essential Job Duties * Develops diagnosis-related group… more
    Molina Healthcare (11/02/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Houston, TX)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/01/25)
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  • Care Review Clinician ( RN ) Prior…

    Molina Healthcare (Houston, TX)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Fully remote opportunity for a TX licensed RN with Utilization Management experience to join...Note. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are… more
    Molina Healthcare (10/29/25)
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  • Medical Claim Review Nurse

    Molina Healthcare (Houston, TX)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
    Molina Healthcare (09/06/25)
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  • Case Manager

    Apex Health Solutions (Houston, TX)
    …will consider remote deployment on a case by case basis Education Education: Registered Nurse ( RN ) LICENSES/CERTIFICATIONS: Registered Nurse ( ... communication skill Some travel in the Houston metro area may be required Remote deployment will be considered SKILLS Knowledge of healthcare delivery Ability to… more
    Apex Health Solutions (08/24/25)
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