9 utilization review case manager jobs at 6 companies in Houston, TX
3mo
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UTILIZATION REVIEW NURSE - RN
Houston, Texas, United States
OnsiteFull Time
2+ YOERN with ADN or BSN; 2+ years acute care; 3+ years utilization review/case management; InterQual/MCG experience; TX RN license; strong analytical and communication skills.
InterQual, MCG, EHR, Meditech, Microsoft Office
1w
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Utilization Management Review Nurse
Harris County, Texas, United States
RemoteFull Time
5+ YOEBachelor's in Nursing, Texas RN license, BLS, and 5 years of clinical experience including 2 years in case, quality, utilization management, or coding; ACM or CCM required within 2 years.
Microsoft Word, PC, Microsoft Excel, Microsoft PowerPoint, MCG, Change Healthcare, InterQual
1w
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Utilization Management Review Nurse
Harris County, Texas, United States
HybridFull Time
5+ YOEBachelor of Nursing from an accredited school, Texas RN license, 5 years of clinical experience including 2 years in case, quality, utilization management, or coding, and ACM or CCM within 2 years.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, PC, MCG, Change Healthcare, InterQual
1w
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Case Manager
Bellaire or Houston
FieldFull Time
3+ YOERN license required; nursing diploma, associate degree, or bachelor's degree required. Requires 3 years of pediatric clinical experience in home care, case management, managed care, or utilization review.
2mo
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RN Case Manager
Shenandoah, Texas, United States
OnsiteFull Time
Current Texas RN license required; BSN preferred; ACM or CCM preferred; prior pediatric/rehab/acute/behavioral/complex case management experience preferred; strong communication and utilization review skills a plus.
3d
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Nurse - Clinical Review
Houston, Texas, United States
$65k-$75k/yr RemoteFull Time
2+ YOERN or LPN/LVN graduate with an active unrestricted license and 2+ years in utilization review, case management, or clinical quality improvement; requires Microsoft Office proficiency and healthcare regulatory knowledge.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, National Coverage Determination (NCD), Local Coverage Determination (LCD), HIPAA, URAC, NCQA
2mo
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Case Management Director
Houston, Texas, United States
OnsiteFull Time
3+ YOEThree years hospital-based case management experience including utilization review and discharge planning. CCM or ACMTM preferred. Must complete assessments within scope; active discipline licensure required if applicable. BSN + RN for nursing; bachelor's required for other clinicians.
2mo
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Discharge Planner
Pearland, Texas, United States
OnsiteFull Time
1+ YOEActive Texas RN or LVN/LPN license, 1+ years clinical nursing experience (skilled nursing/long-term/acute care), case management experience preferred, knowledge of Medicare/Medicaid and utilization review, proficiency with EHR (PointClickCare).
Electronic Health Records (EHR), PointClickCare
2mo
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Corporate Director of Care Management
Houston, Texas, United States
OnsiteFull Time
7+ MgmtBSN and MSN required, Texas RN license required, case management certification required or to be obtained within two years, minimum 7 years progressive hospital case management leadership, multi-site leadership, knowledge of utilization review, InterQual, CMS and accreditation standards.
InterQual, EHR