Utilization Review Case Manager RN

The HireOps Staffing LLC is seeking a highly skilled Registered Nurse to join their team in a Utilization Management role. This position offers the opportunity to work with Medicaid and utilize medically accepted criteria to validate medical necessity and appropriateness of treatment plans.Job Summary:This RN will perform initial, concurrent review...

HCA Houston Healthcare Northwest is a 415+ bed acute care hospital in north Houston that has been serving the community for over 40 years. As a Registered Nurse Case Manager, you will play a vital role in facilitating care along a continuum through effective resource coordination to help patients achieve optimal health and access to care.Job SummaryThe RN...

Case Management Professional Job OverviewNexus Health Systems seeks a skilled Case Management Professional to join our team and support the delivery of cost-effective quality care.In this role, you will work collaboratively with healthcare professionals to develop and implement effective care plans that meet the needs of our patients.Key...

Overview:Houston Methodist is seeking a Clinical Utilization Specialist to join our team. As a key member of our healthcare organization, this individual will play a vital role in ensuring high-quality patient care and efficient resource utilization.Job Summary:The Clinical Utilization Specialist will work closely with medical staff, case management, and...

Job SummaryTexas Children's Hospital is seeking a skilled Patient Care Navigator to join our pediatric case management team. As a Pediatric Case Management Specialist, you will play a vital role in optimizing patient outcomes by coordinating care and ensuring seamless transitions between healthcare settings.About the RoleThis position requires a RN license...

Job Title: Healthcare Professional - Case ManagerAbout the Role:We are seeking a highly skilled and dedicated Registered Nurse (RN) Case Manager to join our team at Interim Healthcare in the Baytown area. As a Case Manager, you will play a vital role in delivering high-quality patient care and ensuring seamless coordination with other healthcare...

Join Dane Street as a highly skilled OB/GYN Physician to review medical claims and provide expert interpretations. This role offers the flexibility to customize your schedule and caseload within the week, ensuring a great work-life balance.We are seeking an experienced physician with an active Texas License to work as an independent contractor on a per-case...

Denovo Review is seeking an experienced Injury Litigation Paralegal to join our team in Houston, TX. We offer a competitive salary of $65,000 - $80,000 per year, depending on experience.Job Description:Key Responsibilities Assist attorneys and support staff with managing cases in personal injury litigation, civil litigation, and mass torts. Prepare, draft,...

Denovo Review Overview: We are a leading national plaintiff litigation firm with a proven record of success. Our team of experienced attorneys is dedicated to providing exceptional service to our clients in probate law. With a focus on excellence and collaboration, we create a positive and productive work environment that fosters growth and...

About the RoleWe are looking for a highly skilled Senior Managed Review Specialist to join our team. In this role, you will be responsible for overseeing challenging and fast-paced regulatory or litigation antitrust matters for our clients. Your primary goal will be to drive efficiencies for the success of our clients and lead managed review project...

OverviewThe System Float Pool Case Manager position at Houston Methodist is a registered nurse responsible for planning and coordinating the care of patients in designated hospitals. This role requires collaboration with physicians, healthcare teams, and other stakeholders to ensure high-quality, patient-centered care.JOB SUMMARY:This position holds joint...

About the RoleThis position offers an exciting opportunity to join our team as a Physician Assistant, focusing on appeals and grievances cases for UnitedHealthcare associated companies.As part of this role, you will collaborate with medical directors and supervise physician assistants to ensure ongoing clinical review and adjudication of appeals and...

At Elevance Health, we are seeking a skilled Clinical Case Manager RN to join our team in Houston. This is a challenging and rewarding role that requires strong communication skills, attention to detail, and the ability to work with diverse populations.Job DescriptionAs a Clinical Case Manager RN, you will be responsible for managing the overall care of...

Premier Medical Resources is a dynamic healthcare management company seeking a highly organized and detail-oriented Medical Case Manager to join our team in Northwest Houston, Texas.The ideal candidate will be responsible for overseeing day-to-day operations of our Legal Case Managers, ensuring seamless coordination and scheduling of physicians' testimony...

Career OverviewElevance Health is a leading healthcare company dedicated to improving lives and communities. We offer a wide range of career opportunities for nurses and healthcare professionals.Job Summary:We are seeking an experienced Nurse Care Coordinator to join our team in Southeast Houston, TX. The ideal candidate will have a strong background in case...

About the RoleThe Medical Case Management Professional at Nexus Health Systems Ltd is responsible for promoting safety in the workplace and patient environment, maintaining PHI and HIPAA compliance, and adhering to company and professional ethical, legal, and accreditation/regulatory standards.Key ResponsibilitiesAct as a patient advocate for all facility...

Are you an organized and detail-oriented professional looking for a challenging role in a dynamic law firm? The Edward Law Group is seeking a skilled Personal Injury Legal Assistant to join our team!We are a well-established and respected law firm in Houston, with a strong commitment to delivering exceptional results for our clients. As a Personal Injury...

About This PositionAre you a dedicated and compassionate Registered Nurse seeking a challenging role that allows you to make a meaningful impact on the lives of military personnel? We are looking for an experienced Senior Military Healthcare Case Manager to join our team at Choctaw Global.Job SummaryThis is a unique opportunity to leverage your case...

Job DescriptionWe are seeking a skilled Clinical Case Manager to join our team at The Law Offices of Omar Khawaja. As a key member of our staff, you will provide exceptional support to our clients throughout the personal injury claims process.Key Responsibilities:Manage client cases from treatment to negotiations, ensuring seamless communication and timely...

Join us as a Primary Nurse Case Administrator I at Health Care Service Corporation!As a key member of our team, you will be responsible for performing various tasks related to utilization management, case management, and disease management. This role requires strong communication and organizational skills, as well as the ability to work independently and as...