1mo
Save
Mark Applied
Hide
Utilization Manager
Austin, Texas, United States
$75k-$96k/yr OnsiteFull Time
Master's in Psychology, Counseling, or Social Work; Texas license (RN, RN-APN, PA, LCSW, LPC, or LMFT); valid driver's license and clean driving record; perform utilization reviews, authorizations, and 24/7 hotline coverage.
3mo
Save
Mark Applied
Hide
Utilization Specialist - PRN
El Paso or United States
OnsiteContract
2+ YOEMonitor service utilization to optimize reimbursement; liaison with managed care; review medical necessity; requires high school diploma; clinical experience with relevant population; licensure preferred.
2mo
Save
Mark Applied
Hide
Director of Utilization
El Paso, Texas, United States
OnsiteFull Time
4+ YOELead and manage Utilization Review; ensure compliant, efficient reimbursement; collaborate with physicians and staff; oversee staff management.
5d
Save
Mark Applied
Hide
Director of Utilization
Center Point, Texas, United States
OnsiteFull Time
4+ YOE3+ MgmtBachelor's in nursing or clinical field required, Master's preferred; 4+ years utilization management, 3+ years supervisory experience; clinical experience with population preferred; applicable LPN/RN or clinical licensure required if applicable.
1d
Save
Mark Applied
Hide
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
4w
Save
Mark Applied
Hide
Utilization Review Nurse
Dallas, Texas, United States
$90k-$98k/yr RemoteFull Time
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
3w
Save
Mark Applied
Hide
Utilization Review Specialist
Fort Worth, Texas, United States
OnsiteFull Time
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.
3mo
Save
Mark Applied
Hide
Utilization Review Nurse (55697)
El Paso, Texas, United States
OnsiteFull Time
2+ YOE2+ years Utilization Management experience; RN license in Texas; BSN preferred; knowledge of InterQual/DRGs; strong organizational, communication, and IT skills.
InterQual, Milliman Care Guidelines, ICD-10, DRGs, Microsoft Office, HIPAA
1mo
Save
Mark Applied
Hide
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
2w
Save
Mark Applied
Hide
Utilization Review Specialist (Remote)
El Paso or Chapel Hill or Delray Beach or Jackson
$60k-$62k/yr RemoteFull Time
3+ YOEBA in Psychology or related field, 3–5 years case management/utilization review experience in substance abuse, knowledge of ASAM and medical terminology, KIPU experience required, strong communication and supervisory ability.
KIPU, Best Notes
2mo
Save
Mark Applied
Hide
TIHP Utilization Management Nurse (84124)
Victoria, Texas, United States
OnsiteFull Time
2+ YOERN or LVN with 2+ years Utilization Management and 5+ years acute clinical experience; proficient with MS Office; experience with MCG/InterQual; Texas licensure required or compact license.
Microsoft Office (Word, Excel, Outlook), MCG InterQual
4d
Save
Mark Applied
Hide
Vice President, Utilization Management
Plano, Texas, United States
OnsiteFull Time
10+ YOE10+ years progressive healthcare leadership with multi-facility experience; expertise in utilization management, payer strategy, denial reduction, reimbursement optimization, executive communication, and data-driven decision making.
1mo
Save
Mark Applied
Hide
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.
4d
Save
Mark Applied
Hide
Clinical Utilization Nurse
Plano, Texas, United States
$88k-$115k/yr HybridFull Time
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)
1w
Save
Mark Applied
Hide
Manager - Utilization Management
Dallas, Texas, United States
OnsiteFull Time
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
2mo
Save
Mark Applied
Hide
Utilization Review Nurse
Big Spring, Texas, United States
OnsiteFull Time
5+ YOERN with Texas license; 5 years in clinical nursing; UR experience preferred.
4w
Save
Mark Applied
Hide
Utilization Management Assistant
Bellaire, Texas, United States
OnsiteFull Time
2+ YOEHigh school diploma/GED, 2 years managed care or medical management experience preferred; healthcare/insurance experience preferred. Responsibilities include data entry of referrals, eligibility confirmation, provider/member education, and internal collaboration.
2mo
Save
Mark Applied
Hide
Utilization Management Program Manager-RN
Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Pennsylvania or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
5+ YOEUnencumbered Oregon RN within 90 days, 1 year clinical nursing plus 4 years health-plan utilization management, experience with managed care, data analysis, quality management, and electronic documentation.
Microsoft Office, EPIC, Clinical Care Advanced
1mo
Save
Mark Applied
Hide
Utilization Review Nurse Health Plans - HP Utilization Management
Irving, Texas, United States
OnsiteFull Time
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
1mo
Save
Mark Applied
Hide
Utilization Management RN (Hybrid)
Dallas, Texas, United States
HybridFull Time
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)
Explore Jobs
Expand Your Job Search
Top Cities in Texas for Utilization
- Utilization jobs in Houston, TX
- Utilization jobs in San Antonio, TX
- Utilization jobs in Dallas, TX
- Utilization jobs in Austin, TX
- Utilization jobs in Fort Worth, TX
- Utilization jobs in El Paso, TX
- Utilization jobs in Arlington, TX
- Utilization jobs in Corpus Christi, TX
- Utilization jobs in Plano, TX
- Utilization jobs in Laredo, TX
- Utilization jobs in Lubbock, TX
- Utilization jobs in Garland, TX
- Utilization jobs in Irving, TX
- Utilization jobs in Amarillo, TX
- Utilization jobs in Grand Prairie, TX
- Utilization jobs in Brownsville, TX
- Utilization jobs in McKinney, TX
- Utilization jobs in Frisco, TX
- Utilization jobs in Pasadena, TX
- Utilization jobs in Mesquite, TX