10 utilization review case manager jobs at 6 companies in Pasadena, TX
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UTILIZATION REVIEW NURSE - RN
Houston, Texas, United States
OnsiteFull Time
Nexus Health Systems: Specialized neuro-rehabilitation and pediatric inpatient medical care provider.
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.
Harris Health System: Public healthcare system serving residents of Harris County, Texas.
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
Harris Health System: Public healthcare system serving residents of Harris County, Texas.
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
Texas Children's Hospital: Provides specialized pediatric and maternal healthcare and clinical research.
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.
Nexus Health Systems: Specialized neuro-rehabilitation and pediatric inpatient medical care provider.
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.
Encompass HealthNYSE: EHC: Operates a national network of inpatient rehabilitation hospitals.
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.
The Medical Resort at Pearland: Provides skilled nursing and rehabilitation services to senior residents.
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).
Nexus Health Systems: Specialized neuro-rehabilitation and pediatric inpatient medical care provider.
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.
MD Anderson Cancer Center: Specialized institution providing oncological care, research, and education.
2+ YOEAccredited nursing education, Texas RN license, BLS or CPR, and 2 years nursing experience or 1 year related utilization review, insurance, case management, or medical clearance experience.
The University of Texas MD Anderson Cancer Center: Comprehensive cancer treatment, medical research, and education center.
2+ YOERequires accredited nursing education, Texas RN license, BLS or CPR, and 2 years nursing or 1 year related utilization review, insurance, case management, or medical clearance experience.