Utilization Review Nurse jobs in Houston, TX

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Utilization Review Manager - LCSW, LCP, RN
Centene 163 reviews - Houston, TX
3 years previous case management or utilization review experience in a mental health environment. The Utilization Manager perform duties to authorize and review...
Sponsored by Personified - 16 days ago
RN - Clinical Documentation Specialist
Houston Northwest Medical Center 761 reviews - Houston, TX
Provide clinically based concurrent and retrospective review of inpatient medical records to evaluate the documentation and utilization of acute care services....
Sponsored by Tenet Healthcare - 7 days ago

RN - Field Case Manager II (Remote)

Molina Healthcare 113 reviews - Houston, TX
Concurrent review, utilization review, case manage, ambulance, ambulatory,. Nurse, BSN, MSN, ADN, Field RN, field nurse, telephonic nurse, LPN, LVN, ACSW, AACN,...
4 days ago - save job - email - more...

RN CLINICAL COMM COORD

Houston Methodist 376 reviews - Houston, TX 77030 (Medical area)
Registered Nurse, Bachelor’s degree required. Registered nurse with current Texas license. Risk/benefits, including utilization of expanded donors, high-risk...
2 days ago - save job - email - more...

Prebill Denials RN

Prebill Denial – Houston - Houston, TX
Utilization Review, appeals, denials, managed care contracting, experienced preferred. Prebill Denial Nurse....
HCA Inc - 17 days ago - save job - email - more...

NCLEX RN Faculty PT - Houston, TX and Surrounding Areas

Kaplan 548 reviews - Houston, TX
Current, unencumbered license as a Registered Nurse. Understanding & application of Kaplan methodology with appropriate utilization of the Faculty Manual....
6 days ago - save job - email - more...

Pre-Cert Nurse - RN

Universal American (UAM) - Houston, TX
Reviews service requests submitted by physicians to include review of evidence/clinical documentation and its medical necessity....
5 days ago - save job - email - more...

RN Case Manager II (Nursing Facility)

Molina Healthcare 113 reviews - Houston, TX
Concurrent review, utilization review, case manage, ambulance, ambulatory,. Nurse, BSN, MSN, ADN, Field RN, field nurse, telephonic nurse, LPN, LVN, ACSW, AACN,...
10 days ago - save job - email - more...

Pre-cert Nurse, LVN

APS Healthcare 61 reviews - Houston, TX
Reviews service requests submitted by physicians to include review of evidence/clinical documentation and its medical necessity....
5 days ago - save job - email - more...

Utilization Revue Nurse

Memorial Hermann Healthcare System 117 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....
30+ days ago - save job - email - more...

Behavioral Health Public Sector Care Advocate - Houston, TX

UnitedHealth Group 1,665 reviews - Houston, TX
Managed care or utilization review experience. Mental Health, Behavioral Health, Care Advocate, Case Management, Social Work, Social Worker, Counseling, LPC,...
5 days ago - save job - email - more...

Pre Certification Specialist (Non-Exempt) Houston, TX

CIGNA 762 reviews - Houston, TX
Completes review of non authorized medical claims. Auto approve, refer to Precert Nurse or Medical Director)....
10 days ago - save job - email - more...
Senior Clinical Admin Nurse - Houston, TX! Work from home!
UnitedHealth Group 1,665 reviews - Houston, TX
Experience with prior authorization, utilization management or clinical review is a plus! RN, Nurse, clinical, CMS, compliance, clinical review, utilization...
Sponsored by UnitedHealth Group - 4 days ago
RN Case Manager
HealthCare Support Staffing 31 reviews - Houston, TX
$65,000 a year
Are you an experienced Registered Nurse with hospital case management, utilization review and critical care experience looking for a new opportunity with a...
Easily apply
Sponsored by HealthCare Support Staffing - 5 days ago
Manager, High Risk Case Management - Sugarland or Telecommut...
UnitedHealth Group 1,665 reviews - Houston, TX
Experience in utilization review, concurrent review and/or risk management. RN, Case manager, CBA, Harris County, Houston, TX, Dallas, Texas, Registered Nurse,...
Sponsored by UnitedHealth Group - 18 days ago

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1,665 reviews
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