46 utilization review case manager jobs at 26 companies in Texas
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Utilization Review RN
Portland or Washington or Alaska or California or Montana or New Mexico or Texas
$50-$78/hr HybridPart Time, Full Time
5+ YOEBachelor's degree in nursing, or associate degree with 2+ years related experience; Oregon RN license; five years acute adult medical-surgical, utilization review, or case management experience.
2mo
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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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Director of Utilization Review
Midland or Odessa or New Mexico
OnsiteFull Time
2+ YOERequires an unencumbered Texas RN license or qualifying behavioral health license, 2+ years psychiatric nursing experience, and 2+ years utilization review, case management, or managed care experience.
InterQual, MCG, Electronic Medical Record (EMR)
1w
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Director of Utilization Review
Midland, Texas, United States
OnsiteFull Time
2+ YOERequires a current Texas RN license or qualifying behavioral health license, 2+ years of psychiatric nursing and utilization review, case management, or managed care experience, plus EMR and clinical criteria proficiency.
InterQual, MCG, Electronic Medical Record (EMR), Medicare, Texas Medicaid
2mo
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Utilization Review Coordinator - PRN position
Georgetown, Texas, United States
OnsitePart Time
Prefer bachelor\u0002s (nursing) and 3-5 years admitting/financial counseling experience; 2 years clinical experience preferred. Previous utilization review or case management desirable. Must obtain CPR and facility de-escalation/crisis management certification within 30 days.
3d
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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
2mo
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CASE MANAGER (RN) - UTILIZATION REVIEW (FULL TIME)
Denison, Texas, United States
OnsiteFull Time
3+ YOEActive RN license (state or compact), bachelor’s degree preferred, minimum 3 years clinical or case management/utilization management experience in high-volume acute care, strong communication and problem-solving skills.
3mo
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Nurse Case Manager - Utilization Review - Mon, Tue, Sat, Sun
Fort Worth, Texas, United States
OnsiteFull Time
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.
6d
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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.
1w
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Case Manager
Ennis, Texas, United States
OnsiteFull Time
1+ YOERN, LPN/LVN, or LCSW/LSW state licensure required. Nursing or social work degree required; healthcare experience and case management, utilization review, or discharge planning preferred.
Microsoft Office Suite, Electronic Medical Records (EMR)
1mo
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Case Manager RN
Mission, Texas, United States
OnsiteTemporary
1+ YOERN case manager overseeing care coordination, discharge planning, utilization review; requires bachelor\u0002s degree (BSW or related), RN, BCLS preferred, and 1+ year case management or nursing experience.
Milliman Criteria, InterQual Criteria
1mo
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Supervisor, Utilization Management
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$91k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtCurrent RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, ICD, DSM, CPT, HCPCS, American Dental codes, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet
3w
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Case Manager
McAllen, Texas, United States
OnsiteFull Time
Managing admissions, insurance authorizations, utilization review, Section GG/PDPM scoring, discharge planning, payer communication, and regulatory-compliant documentation in post-acute settings.
3w
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Case Manager
McAllen, Texas, United States
OnsiteFull Time
Coordinating admissions, insurance authorizations, utilization reviews, care planning, discharge planning, and ensuring regulatory compliance for skilled nursing residents.
3w
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RN Case Manager/UR Reviewer
Lubbock, Texas, United States
OnsiteFull Time
2+ YOECurrent Texas RN license or MSW, 2+ years medical/psychiatric case management or utilization review, 3+ years acute care preferred, knowledge of Texas Medical Foundation and Interqual criteria, medical terminology, strong communication under stress.
3w
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RN Case Manager/UR Reviewer
Lubbock, Texas, United States
OnsiteFull Time
3+ YOECurrent Texas RN license (or MSW), 2+ years case management/utilization review experience, 3+ years acute care experience preferred, knowledge of Interqual and Texas Medical Foundation criteria, medical terminology, strong communication and critical thinking.
Interqual
1mo
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Case Manager - FT
Flower Mound, Texas, United States
OnsiteFull Time
4+ YOEDevelop and coordinate patient care plans, perform utilization reviews, support discharge planning, document clinical activity, maintain clinical licensure or equivalent experience, and maintain driving eligibility.
2mo
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Clinical Review Specialist (31389)
Southlake, Texas, United States
$65k-$90k/hr OnsiteFull Time
5+ YOENursing degree or diploma with LVN or RN in good standing, 5+ years nursing experience, 1+ year case management/utilization review, knowledge of CPT/ICD-10 and payer guidelines, strong communication and documentation skills.
CPT, ICD-10
2mo
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Case Management Assistant
Center Point, Texas, United States
OnsiteFull Time
1+ YOEHigh school diploma required (associate preferred). 1+ year behavioral health experience preferred. CPR and de-escalation/restraint certification required (training provided). Experience in case management/utilization review preferred.
2mo
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RN Case Manager-FT- Days- Res Mgmt
Edinburg, Texas, United States
OnsiteFull Time
3+ YOEGraduate of accredited nursing program, active Texas RN license, 3+ years clinical experience (hospital/acute care preferred), case management knowledge, InterQual/Milliman experience desirable, bilingual English/Spanish, discharge planning and utilization review skills.
InterQual, Milliman
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