Utilization Review Nurse jobs in Houston, TX

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RN Patient Care Navigator
East Houston Regional Medical Center - Houston - Houston, TX
Reviews patient case lists generated by. Evaluates and provides input regarding the utilization of resources to meet the needs of the target population. The....
Sponsored by HCA Inc
Behavioral Health Care Manager
WellCare - 615 reviews - Houston, TX 77082
Licensed Registered Nurse (RN) is required. Ability to create, review and interpret treatment plans. Acute Care Nurse Practitioner (APRN) (ACNP-BC) is required...
Sponsored
Supp Case Manager
Completes Utilization Management and Quality Screening for assigned patients. The role integrates and coordinates utilization management, care facilitation and...
Sponsored

Medical Claims Review Nurse RN

UnitedHealth Group - 4,825 reviews - Houston, TX
Background involving utilization review for an insurance company or experience in case management. Perform clinical coverage review services, which require...

Utilization Review Nurse

Catapult Consultants - 5 reviews - Houston, TX
2 years utilization/quality assurance review. Active license as a Registered Nurse (RN). 5 years clinical experience or equivalent experience in the medical...

Utlization Review Nurse

Medix - 61 reviews - Houston, TX
The Utilization Review Nurse serves as a contact and resource person to Health Solutions' members to the utilization review (UR) of healthcare services....

Medical Review Nurse

NCI Information Systems, Inc. - 2 reviews - Houston, TX
As the Medicare Medical Review Nurse ( Medical Reviewer ), you will primarily responsible for conducting clinical reviews of medical records during the course...

CCM Worker's Compensation RN - Utilization Review Experience

Managed Care - Houston, TX
Registered Nurse (RN). Responsible for assessment, planning, coordination, implementation and evaluation of injured/disabled individuals involved in the medical...
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On Site Utilization Management Coordinator (RN)

Blue Cross Blue Shield of IL, MT, NM, OK & TX - 11 reviews - Houston, TX
Utilization management experience. This position is responsible performing initial, concurrent review activities;...

RN Clinical Appeals Nurse

Christus Health - 183 reviews - Houston, TX 77008 (Greater Heights area)
Two to four years of Utilization Review/Case Management experience. Review governmental contractors response letter in comparison to the medical records....

SIU Investigator (RN) Houston,TX

Molina Healthcare - 349 reviews - Houston, TX
Licensed Registered Nurse (RN). The purpose of this role is to investigate and detect potential health care fraud, waste and abuse through the identification of...

Revenue Integrity Specialist

Harris Health System - 126 reviews - Houston, TX 77054 (Medical area)
CPC, CPC-H, CCS, or Registered Nurse/Licensed Vocational Nurse preferred. Johnson and Quentin Mease — achieved Pathway to Excellence™ designation by the...

Utilization Review Case Manager CMC

The University of Texas Medical Branch - 416 reviews - Friendswood, TX
Utilization Review Case Manager CMC. TDCJ, Case Management, Utilization Review, or Managed Care experience a plus....
Case Manager II
Completes Utilization Management and Quality Screening for assigned patients. The role integrates and coordinates resource utilization management, care...
Sponsored
Case Manager - ED/OBS (Monday- Friday)
Memorial Hermann - 976 reviews - Sugar Land, TX
Completes Utilization Management and Quality Screening for assigned patients. The role integrates and coordinates resource utilization management, care...
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