• Staff Utilization Management

    Humana (Austin, TX)
    …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
    Humana (01/10/26)
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  • Utilization Management Nurse…

    CVS Health (Austin, TX)
    …of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare ... expertise to enhance their understanding of utilization management principles and improve their clinical decision-making.... clinical setting with diverse cultural dynamics of clinical staff and patients. Registered Nurse (RN)… more
    CVS Health (01/01/26)
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  • Centralized Utilization Review Manager

    Houston Methodist (Katy, TX)
    Utilization Review department to ensure efficient, high-quality, and compliant utilization management practices across the organization. This position ensures ... as a subject matter expert and front-line leader, guiding clinical and non- clinical staff in...preferred **EXPERIENCE** + Five years' experience in inpatient case management , social work or utilization management more
    Houston Methodist (01/14/26)
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  • Utilization Management Behavioral…

    Humana (Austin, TX)
    …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
    Humana (01/10/26)
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  • Director Centralized Utilization Review

    Houston Methodist (Katy, TX)
    …is responsible for strategic, administrative, and operational leadership for the Utilization Management (UM) department across the Houston Methodist system. ... on medical necessity and level-of-care criteria. + Oversees the denials management clinical team for concurrent, retrospective, and self-denial processes.… more
    Houston Methodist (01/14/26)
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  • Utilization Review Case Mgr - CMC - Clear…

    UTMB Health (Webster, TX)
    …activities/projects + Provides assistance regarding clinical issues to non-nursing utilization review staff + Demonstrates support of the department and ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions,… more
    UTMB Health (12/12/25)
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  • Clinical Staff Pharmacist…

    UTMB Health (Huntsville, TX)
    Clinical Staff Pharmacist - Huntsville Central Pharmacy **Huntsville, Texas, United States** Allied Health UTMB Health Requisition # 2507177 The mission of ... provision of safe, effective, and timely medication therapy through drug utilization review and collaboration with other healthcare professionals. Responsible for… more
    UTMB Health (12/19/25)
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  • RN Clinical Manager, Home Health

    CenterWell (San Angelo, TX)
    …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
    CenterWell (01/03/26)
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  • Clinical Pharmacist Specialist BMT

    HCA Healthcare (Dallas, TX)
    …The Clinical Specialist shall also assist in mentoring pharmacy staff and precepting students/residents and assist in the evaluation and implementation of ... staff and patients + Leads and develops pharmacy clinical services such as drug consults, nutrition support, pharmacokinetics, anticoagulant monitoring,… more
    HCA Healthcare (01/11/26)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Paris, TX)
    …as a resource to facility staff . + Provides counseling for all clinical staff members at regular intervals offering support and encouraging professional ... to the disease management company. Maintains current knowledge of disease management software and systems as pertinent. ** STAFF :** + Responsible for… more
    Fresenius Medical Center (10/30/25)
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  • Director of Pharmacy - Clinical Services

    UTMB Health (Galveston, TX)
    …the delivery of high-quality, evidence-based, and cost-effective medication therapy management , aligning with organizational goals for clinical excellence, ... of all clinical pharmacy programs. This includes leadership of formulary management , medication-use evaluation, and clinical program innovation, as well as… more
    UTMB Health (12/31/25)
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  • Clinical Resource Nurse

    Houston Methodist (Houston, TX)
    …liaison between other departments, vendors, surgeons, anesthesia, and Operating Room (OR) staff , assisting management with the coordination and facilitation of ... and organizational commitments + Able to work independently; possess organization/time management and prioritization skills + Demonstrates sound clinical problem… more
    Houston Methodist (01/14/26)
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  • Advanced Clinical Pharmacist

    HCA Healthcare (San Antonio, TX)
    utilization review to promote rational drug therapy, leading and developing clinical services, mentoring and educating staff to ensure accurate and ... We care like family! Jump-start your career as a(an) Advanced Clinical Pharmacist today with Methodist Hospital Specialty and Transplant. **Benefits** Methodist… more
    HCA Healthcare (01/04/26)
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  • Advanced Clinical Pharmacist Critical Care

    HCA Healthcare (Live Oak, TX)
    utilization review to promote rational drug therapy, leading and developing clinical services, mentoring and educating staff to ensure accurate and ... We care like family! Jump-start your career as an Advanced Clinical Pharmacist Critical Care today with Methodist Hospital Northeast. **Benefits** Methodist… more
    HCA Healthcare (10/26/25)
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  • Advanced Clinical Pharmacist

    HCA Healthcare (Fort Worth, TX)
    staff and patients** + **Actively participate in pharmacy clinical services such as drug consults, nutrition support, pharmacokinetics, anticoagulant monitoring, ... other programs as defined by Pharmacy Leadership.** + **Participate in the antimicrobial management and other clinical programs** + **Document all clinical more
    HCA Healthcare (01/13/26)
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  • Pharmacy Clinical Specialist - Oncology

    Houston Methodist (The Woodlands, TX)
    …PGY1 or PGY2 pharmacy residents as well as being a mentor for staff pharmacists supporting clinical skill advancement. **SERVICE ESSENTIAL FUNCTIONS** + ... medication use evaluations, adverse drug reaction and medication error reporting, clinical interventions, medication center reviews, and inventory management more
    Houston Methodist (01/10/26)
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  • Clinical Administrative Director, Brain…

    MD Anderson Cancer Center (Houston, TX)
    …Development, Support and Management ** Manage human resources including clinical , administrative and clerical staff . Oversee the selection, supervision, ... quality benchmarks and implement plans to promote the professional development of clinical staff . Identify opportunities to utilize data about performance… more
    MD Anderson Cancer Center (01/14/26)
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  • Lead Clinical and Population Health Analyst…

    Highmark Health (Austin, TX)
    …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... Utilize robust, data-driven insights from complex healthcare datasets (eg, claims, clinical , utilization , pharmaceutical) to inform policy development, identify… more
    Highmark Health (12/31/25)
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  • Physician Advisor | Case Management

    Houston Methodist (Houston, TX)
    …effectively with all healthcare disciplines. + Demonstrates understanding and knowledge of utilization management , clinical documentation, and state and ... and alternative levels of care. Provide consultation to case management staff regarding complex clinical ...medical staff committees that interface with the utilization review/ management committee. Assist with the evaluation… more
    Houston Methodist (01/10/26)
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  • Clinical Manager

    HCA Healthcare (Plano, TX)
    …and objectives + Under the direction of the TC AVP, work collaboratively with HCA clinical and medical staff advisors and client designated medical staff ... to establish, revise, and enforce the clinical and medical staff participation criteria for transfer operations, throughput, and communications operations + In… more
    HCA Healthcare (12/24/25)
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