• Utilization Review Case

    Dallas Behavioral Healthcare Hospital (Desoto, TX)
    The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
    Dallas Behavioral Healthcare Hospital (10/30/25)
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  • Behavioral Health - Case Manager

    Texas Health Resources (Arlington, TX)
    …Years Clinical psychiatric or chemical dependency experience Required and * 6 Months in case management or utilization review Required * Prior experience ... Behavioral Health - Case Manager _Bring your passion to...Preferred What You Will Do Daily Payor and Chart Review Activities Identifies those cases requiring certification or re-certification… more
    Texas Health Resources (12/26/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Grand Prairie, TX)
    **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
    Elevance Health (12/20/25)
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  • Telephonic Nurse Case Mgr II

    Elevance Health (Grand Prairie, TX)
    **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
    Elevance Health (12/24/25)
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  • Clinical Manager , Home Health

    CenterWell (Cleburne, TX)
    …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... comes with a $10K sign-on bonus.** + The **Clinical Manager ** coordinates and oversees all direct care patient services...clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the… more
    CenterWell (12/19/25)
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  • Behavioral Health - Care Manager II

    Elevance Health (Grand Prairie, TX)
    …services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with ... **Behavioral Health - Care Manager II** **Location:** _Virtual:_ This role enables associate...outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses… more
    Elevance Health (12/22/25)
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  • Behavioral Health Care Manager I

    Elevance Health (Grand Prairie, TX)
    …supervision. **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management/ utilization management with a broad range of experience ... **Behavioral Health Care Manager I** **Virtual:** This role enables associates to...outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact** Primary duties… more
    Elevance Health (12/18/25)
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  • Medical Review Nurse (RN)

    Molina Healthcare (Fort Worth, TX)
    …At least 2 years clinical nursing experience, including at least 1 year of utilization review , medical claims review , long-term services and supports (LTSS), ... Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM),… more
    Molina Healthcare (12/26/25)
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  • Medical Director (NV)

    Molina Healthcare (Fort Worth, TX)
    …in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership ... Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of… more
    Molina Healthcare (11/21/25)
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  • Medical Management Nurse

    Elevance Health (Grand Prairie, TX)
    …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education and ... + ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review experience is preferred. + Knowledge of the medical management… more
    Elevance Health (12/26/25)
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  • Director Care Transition

    Texas Health Resources (Arlington, TX)
    …Upon Hire Required And CPR - Cardiopulmonary Resuscitation Upon Hire Required And ACM - Accredited Case Manager Upon Hire Preferred Or CCM - Certified Case ... Manager Upon Hire Preferred Or CPUM - Certified Professional Utilization Manager Upon Hire Preferred Or Other ANCC Upon Hire Preferred Skills Knowledge of… more
    Texas Health Resources (12/18/25)
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  • Director Care Transition

    Texas Health Resources (Bedford, TX)
    …Upon Hire Required And CPR - Cardiopulmonary Resuscitation Upon Hire Required And ACM - Accredited Case Manager Upon Hire Preferred Or CCM - Certified Case ... Manager Upon Hire Preferred Or CPUM - Certified Professional Utilization Manager Upon Hire Preferred Or Other ANCC Upon Hire Preferred Skills Knowledge of… more
    Texas Health Resources (12/06/25)
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  • Associate Medical Director - Sleep Medicine

    Elevance Health (Grand Prairie, TX)
    …Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit Management/ Utilization Review ** **Virtual:** This role enables associates ... necessity decisions. + Brings to their supervisors attention, any case review decisions that require + Medical...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (12/13/25)
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