• Medical Claim Review Nurse (RN)

    Molina Healthcare (Dallas, TX)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level… more
    Molina Healthcare (01/25/25)
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  • Nurse Manager - CV ICU

    Texas Health Resources (Dallas, TX)
    ** Nurse Manager - CV ICU** _Are you looking for...for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health Dallas ... + Core work hours: Monday-Friday 8:00a-5:00p For more than a half-century, Texas Health Presbyterian Hospital Dallas has been at the forefront of health care in… more
    Texas Health Resources (01/23/25)
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  • Nurse Manager I - Neuro Trauma ICU

    Texas Health Resources (Dallas, TX)
    ** Nurse Manager Nureo Trauma ICU** _Are you looking...for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health ... Dallas + Core work hours: Monday-Friday 8:00a-5:00p For more than a half-century, Texas Health Presbyterian Hospital Dallas has been at the forefront of health more
    Texas Health Resources (11/30/24)
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  • Nurse Reviewer I

    Elevance Health (Grand Prairie, TX)
    …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
    Elevance Health (01/24/25)
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  • Operating Room Registered Nurse

    HCA Healthcare (Dallas, TX)
    …any other healthcare provider. We are seeking an Operating Room Registered Nurse to join our healthcare family. **Benefits** Park Central Surgical Center, offers ... a total rewards package that supports the health , life, career and retirement of our colleagues. The...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
    HCA Healthcare (11/23/24)
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  • OR Registered Nurse PRN

    HCA Healthcare (Dallas, TX)
    …satisfaction and personal growth, we encourage you to apply for our OR Registered Nurse PRN opening. We review all applications. Qualified candidates will be ... you have the career opportunities as a OR Registered Nurse PRN you want with your current employer? We...Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
    HCA Healthcare (01/22/25)
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  • OR Registered Nurse PRN

    HCA Healthcare (Dallas, TX)
    …satisfaction and personal growth, we encourage you to apply for our OR Registered Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an OR Registered Nurse PRN you want with your current employer? We...Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
    HCA Healthcare (12/05/24)
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  • Operating Room Registered Nurse

    HCA Healthcare (Dallas, TX)
    …your career path, we encourage you to apply for our Operating Room Registered Nurse opening. We review all applications. Qualified candidates will be contacted ... have the career opportunities as an Operating Room Registered Nurse you want in your current role? We invest...Spine, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
    HCA Healthcare (10/29/24)
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  • Director Care Management

    Methodist Health System (Dallas, TX)
    …of anticipated impact of external regulations and cost-containment efforts related to Utilization Review , Case Management. * Attains all agreed to goals ... required. * Master's degree in Nursing, Health Care Administration, Public Health , Business Administration, preferred. * Registered nurse graduated from an… more
    Methodist Health System (01/01/25)
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  • Medical Director

    Molina Healthcare (Dallas, TX)
    …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
    Molina Healthcare (12/26/24)
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  • Home Health Clinical Manager

    HCA Healthcare (Irving, TX)
    **Description** **Introduction** We are seeking a Home Health Clinical Manager with Medical City Healthcare at Home to promote growth and unlock possibilities. At ... City Healthcare at Home, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and programs… more
    HCA Healthcare (01/09/25)
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  • RN Digestive Health Navigator

    AdventHealth (Mansfield, TX)
    …Program - Career Development - Whole Person Wellbeing Resources - Mental Health Resources and Support - Debt-free Education* (Certifications and Degrees without ... Clinical Ladder Program* **Our promise to you:** Joining Texas Health Hospital Mansfield - AdventHealth is about being part...career with AdventHealth, named in 2018 by Becker's Hospital Review as one of the "150 Top Places to… more
    AdventHealth (12/27/24)
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  • Care Transition Navigator Sal

    Methodist Health System (Dallas, TX)
    …planning while supporting a balance of optimal care and appropriate resource utilization . The Care Transitions Navigator will identify potential barriers to patient ... Social Work, Master's degree in Social Work * Registered Nurse with BSN preferred * 1 year of experience...with BSN preferred * 1 year of experience in health related setting * Hospital case management experience preferred… more
    Methodist Health System (01/03/25)
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  • Care Transition Navigator SAL

    Methodist Health System (Dallas, TX)
    …planning while supporting a balance of optimal care and appropriate resource utilization . The Care Transitions Navigator will identify potential barriers to patient ... Social Work, Master's degree in Social Work * Registered Nurse with BSN preferred * 1 year of experience...with BSN preferred * 1 year of experience in health related setting * Hospital case management experience preferred… more
    Methodist Health System (11/26/24)
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  • PRN Care Transition Navigator

    Methodist Health System (Midlothian, TX)
    …planning while supporting a balance of optimal care and appropriate resource utilization . The Care Transitions Navigator will identify potential barriers to patient ... Bachelor's degree in Social Work, Master's degree in Social Work, Registered Nurse with BSN preferred. Hospital case management experience preferred * LMSW/LBSW, or… more
    Methodist Health System (01/17/25)
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  • Case Coordinator - Denials

    Methodist Health System (Dallas, TX)
    …initiatives while supporting the mission, vision, value and strategic goals of Methodist Health System. Your Requirements: * Bachelors of Science degree in Nursing - ... REQUIRED for Nursing professionals * Current license from respective agency for non- nurse professionals- PREFERRED * CCM in Case Management - PREFERRED Your… more
    Methodist Health System (01/11/25)
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  • Care Transition Navigator

    Methodist Health System (Midlothian, TX)
    …planning while supporting a balance of optimal care and appropriate resource utilization . The Care Transitions Navigator will identify potential barriers to patient ... Social Work, Master's degree in Social Work * Registered Nurse with BSN preferred * 1 year of experience...with BSN preferred * 1 year of experience in health related setting * Hospital case management experience preferred… more
    Methodist Health System (01/08/25)
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  • RN Team Lead M/S Days

    AdventHealth (Mansfield, TX)
    …service of selected patient populations across the continuum of illness; promotes effective utilization of and monitors health care resources; and assumes a ... Career Development - Whole Person Wellbeing Resources - Mental Health Resources and Support - Debt-free Education* (Certifications and...career with AdventHealth, named in 2018 by Becker's Hospital Review as one of the "150 Top Places to… more
    AdventHealth (12/13/24)
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  • Clinical Documentation Specialist

    Houston Methodist (Dallas, TX)
    …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year ... experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure within 60 days… more
    Houston Methodist (12/03/24)
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  • COE CM Director, (RN required)

    Molina Healthcare (Dallas, TX)
    …establishing best practices and driving standardization and results across Molina Health Plans & Segments. **KNOWLEDGE/SKILLS/ABILITIES** + Review existing case ... Active, unrestricted State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care… more
    Molina Healthcare (12/12/24)
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