Utilization Review Nurse jobs in Houston, TX

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Transitional Care RN / Case Managers
MedCore Talent 4 reviews - Houston, TX
Review of BPCI process and outcomes performance to drive performance. Success in the role will be defined by reductions in avoidable patient complications and...
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Sponsored by MedCore Talent - 4 days ago
Case Manager- Full Time Days
Cornerstone Healthcare Group 16 reviews - Houston, TX
Coordinates discharge planning to ensure continuity of care, performing utilization review, and facilitating the patient satisfaction survey process....
Sponsored by Cornerstone Healthcare Group - 26 days ago

Clinical Appeals Reviewer/Case Manager

Addison Healthcare 3 reviews - Houston, TX 77076 (North area)
A Houston LTAC Hospital Facility I work with is looking for an LVN/RN to work onsite and do their clinical appeals, auditing, and utilization review....
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RN Clinical Appeals Nurse

Christus Health 101 reviews - Houston, TX
The Clinical Appeals Nurse will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), Inter....

Nurse Supervisor Case Management (Non-remote; Nursing Facili...

Molina Healthcare 142 reviews - Houston, TX
Concurrent review, utilization review, case manage, ambulance, ambulatory,. Functions as hands-on supervisor for daily Case Management activities including...

Prebill Analyst

Prebill Denial – Houston - Houston, TX
The Prebill Denials Analyst will escalate medical review request and/or denial activities to the Prebill Denials Nurse....


Houston Methodist 417 reviews - Houston, TX 77030 (Medical area)
Some experience with utilization review/management and/or pre-certification processes. Completes routine reviews of billed services and supporting medical...


Cypress Fairbanks Medical Center 895 reviews - Houston, TX
Quality, Case Management and/or Utilization Reviewexperience preferred; This position integrates care coordination, utilization management, and discharge...

Medical Case Manager - Field/Utilization Review - TMC

TRISTAR Risk Management 17 reviews - Houston, TX
Current, active nurse licensure. Evaluate treatment requests and review clinical information received with treatment protocols and guidelines, identify medical...

Nurse Medical Management I - Houston, Texas

Anthem, Inc. 582 reviews - Houston, TX
The ideal candidate must have acute care clinical or utilization review experience. Conducts pre-certification, inpatient, retrospective, out of network and...

Registered Nurse (RN) Case Mgr II (Nursing Facility; Remote)

Molina Healthcare 142 reviews - Houston, TX
Concurrent review, utilization review, case manage, ambulance, ambulatory,. Nurse, BSN, MSN, ADN, NCSN, PNP, Field RN, field nurse, telephonic nurse, LPN, LVN,...

RN Medical Case Mgr - Workers Compensation

The Travelers Companies, Inc. - Houston, TX
For nurses handling Workers Compensation Claims, perform Utilization Review according to established guidelines....
DISCHARGE NURSE - Full Time - Days
Houston Methodist 417 reviews - Houston, TX
Review Discharge Orders. Registered Nurse with current Texas license. The Discharge Nurse is a Registered Nurse, who as an experienced clinician functions at...
Sponsored by Houston Methodist - 30+ days ago
Nurse, RN, Ambulatory - Hematology / Oncology, RELOCATION AS...
Nemours 53 reviews - Houston, TX
Career, Employment, Jobs, Opening, Occupation, Compensation, Salary, Hospital, Health Care, Healthcare, Medical, Clinical, Pediatrics, Pediatric, Children,...
Sponsored by Nemours - 11 days ago
Registered Nurse RN Transitional Care Case Manager
MedCore Talent 4 reviews - Houston, TX
Core Talent has been selected by a well respected progressive healthcare organization to screen and recruit the ideal Transitional Care Registered Nurse to...
Sponsored by CareerVitals.com - 7 days ago

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Company with Utilization Review Nurse jobs
4 reviews
MedCore Talent is a boutique executive search and consulting firm providing recruiting solutions to world-class healthcare organizations.