• 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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  • Concurrent Review Nurse

    Actalent (Houston, 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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  • Medical Claim Review Nurse (RN)

    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 ... work remotely anywhere within the United States. Work Schedule Monday to Friday - operation hours 6 AM to...Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge… more
    Molina Healthcare (07/03/25)
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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 (06/25/25)
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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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  • 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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