726 utilization jobs at 303 companies in Dallas, TX
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Utilization Review Nurse
Dallas, Texas, United States
$90k-$98k/yrRemoteFull Time
Cobalt Benefits Group: Manages self-funded health and dental benefit plans for employers.
3+ YOECurrent unrestricted RN license, 3+ years clinical nursing, 1+ year UM/UR experience, proficiency with Microsoft Excel/Word/Outlook/Teams and utilization management systems; strong analytical and communication skills.
Microsoft Excel, Microsoft Word, Microsoft Outlook, Microsoft Teams, Milliman
ACH Child and Family Services: Provides foster care, adoption, and child welfare services.
3+ YOEBachelor's degree required (master's in social work preferred); minimum 3 years experience with children/youth in foster care; experience with utilization management in behavioral/medical settings; strong communication and organizational skills; valid driver's license and personal vehicle required.
CSI Pharmacy: Provides specialty pharmacy and in-home infusion therapy services.
2+ YOEReview clinical referrals and prior authorizations, draft LMNs and appeals, perform initial assessments and care plans, coordinate with prescribers, and monitor patient outcomes; RN/NP with infusion experience preferred.
Monday.com, MS-teams, Microsoft Office, Windows, Cover My Meds (CCM)
North Texas Behavioral Health Authority: Providing community-based mental health and substance use disorder services.
3+ YOE1+ MgmtLicensed clinician (LPHA,RN,PA,LPC,LCSW,LMFT) in Texas, 3+ years direct serious mental illness experience, 1+ year UM implementation/supervisory experience, valid Texas driver, knowledge of TRR/TAC, strong clinical decision-making and documentation skills.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, CMBHS
Utilization Review Nurse Health Plans - HP Utilization Management
Irving, Texas, United States
OnsiteFull Time
CHRISTUS Health: Catholic nonprofit health system providing comprehensive medical services.
LVN required (state or compact), RN preferred; 3–5 years nursing experience preferred; proficiency with InterQual/MCG/CMS criteria, Microsoft Outlook/Teams/Word/Excel; strong communication and critical thinking; able to take after-hours calls.
InterQual, MCG, Centers for Medicare and Medicaid Services (CMS) Inpatient List, Microsoft Outlook, Microsoft Teams, Microsoft Word, Microsoft Excel
Texas Connect, Inc.: Provides management and administrative services to healthcare provider organizations.
2+ YOECurrent CA RN licensure or willingness to obtain, 2+ years bedside acute care, 2+ years case management, knowledge of payer requirements, strong communication and organizational skills, basic MS Office skills, ability to apply UM criteria, typing 50 WPM.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Milliman Care Guidelines (MCG)
BasePoint Academy: Provides behavioral healthcare and mental health treatment for adolescents
5+ YOE2+ MgmtMaster’s degree in a related clinical field with active licensure; 5+ years UM in behavioral health with commercial payors; 2+ years people leadership; cross-functional experience; TX payor knowledge.
High school diploma required (AA preferred). Ability to handle high-volume calls, enter and verify patient/provider data, use CareMC and Microsoft Office/Excel, strong written/verbal communication and organizational skills.
Texas Institute for Surgery: Physician-owned hospital providing specialized orthopedic and spinal surgical services.
3+ YOECurrent Texas RN license and BLS, Associate's degree in nursing (Bachelor's preferred), 3+ years acute care experience, experience with InterQual or Milliman criteria, strong communication and analytical skills, and valid driver’s license.
Universal Health ServicesNYSE: UHS: Operates acute care hospitals and behavioral health facilities.
2+ YOEDegree in social work/mental health/nursing preferred; 2+ years healthcare or managed care experience preferred; licensure (RN, LVN, LMSW, LPC) preferred; CPR, Handle with Care and Verbal De-Escalation training required within 30 days.
AccentureNYSE: ACN: Global provider of management consulting and technology services.
5+ YOE5+ years in Healthcare IT in an Epic non-clinical leader role, Epic Tapestry certification and certification in an Epic non-clinical app, bachelor's degree or equivalent, project planning, stakeholder communication, and system configuration/testing experience.
City of Garland: Provides municipal services and public administration for Garland, Texas.
3+ YOE3+ years (Operator II) or 6+ years (Operator III) wastewater experience, TCEQ Class B (II) or Class A (III) license, high school diploma/GED, valid Texas driver's license, ability to work in hazardous outdoor conditions.
North Texas Municipal Water District: Provides regional wholesale water, wastewater, and solid waste services.
3+ YOEHigh school diploma/GED, TCEQ Class B wastewater operator license, valid Texas driver's license, 3+ years wastewater experience, knowledge of wastewater processes, testing, troubleshooting, and basic computer skills.
Standard Utility Construction: Constructs and maintains electrical utility infrastructure throughout Texas.
2+ YOE2+ years underground electric distribution experience; able to work energized/de-energized lines up to 600V, computer literate, basic math, read meters and drawings, English fluency, valid Texas driver license; Class A CDL preferred.
Nurse Case Manager - Utilization Review - Mon, Tue, Sat, Sun
Fort Worth, Texas, United States
OnsiteFull Time
JPS Health Network: Public health system providing medical care and residency training.
3+ YOERN with 3-5 years in clinical, case management, utilization review, or discharge planning; Bachelor's required; Texas RN licensure; ACM certification preferred; Master’s in Nursing preferred.
Utilization Management Medical Director - Medical Oncology - Remote anywhere in US
Houston or Chicago or Atlanta or Phoenix or Los Angeles or Saint Louis or San Diego or Dallas or Philadelphia or Seattle
$249k-$373k/yrRemoteFull Time
UnitedHealth GroupNYSE: UNH: Provides health insurance and technology-enabled health care services.
5+ YOEMD or DO with current medical license; Board Certification in Oncology; 5+ years clinical experience in oncology; NCCN guideline experience; able to support utilization review and case/disease management.
Dallas or Indiana or Kentucky or Nevada or Oregon or Oklahoma or South Carolina or Texas or United States
RemoteContract
Medical Review Institute of America: Provides independent clinical and utilization review services for healthcare.
5+ YOEBoard-certified dermatologist with MD or DO, unencumbered state medical license in IN/KY/NV/OR/OK/SC/TX, 5+ years clinical experience (including residency), daytime availability, HIPAA compliance.
NTT DATATokyo Stock Exchange: 9613: Global provider of business and technology consulting and IT services.
15+ YOE15+ years in the utility industry with deep utility domain expertise, consulting/advisory experience, proven C‑suite engagement, and ability to translate utility challenges into digital/AI transformation strategies.