117 utilization opportunities in Houston updated today
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· Page 1 / 6Healing Body and Mind. NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it’s nee
Behavioral Health Utilization Management Medical Case Manager CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready
PwCSpecialty/Competency: Operations Industry/Sector: Health Services Time Type: Full time Travel Requirements: Up to 80% At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs
Come lead with us at Corporate At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading the daily operations of the Utilization Review department to ensure efficient, high-quality, and compliant utilization management practices across the organization
## Job Details Career area CHC Clinical Position Type Full Time Pay $67,200.00 - $85,000.00 Location CHC Loop Central - Remote, Houston, TX 77081, United States Job ID 179313 Facebook X LinkedIn Email Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed
At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators and criteria as approved by
## Job Details Career area CHC Clinical Position Type Full Time Pay $67,200.00 - $85,000.00 Location CHC Loop Central - Remote, Houston, TX 77081, United States Job ID 179312 Facebook X LinkedIn Email Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed
Job Summary And Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making, regulatory compliance, and responsible resource utilization. Every day, you will meticulously review medi
CommonSpirit HealthJob Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making, regulatory compliance, and responsible resource utilization. Every day, you will meticulously review medi
Come lead with us at Corporate At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading the daily operations of the Utilization Review department to ensure efficient, high-quality, and compliant utilization management practices across the organization
Come lead with us at Corporate At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading the daily operations of the Utilization Review department to ensure efficient, high-quality, and compliant utilization management practices across the organization
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated a
AccentureAccenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a
OptumExplore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated a
Payment Operations Manager About Autura Autura is the leading software platform for the towing and recovery industry, providing purpose-built solutions that help towing operators run more efficient, profitable businesses. Our integrated product suite spans dispatch, impound management, compliance, a
Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision‑making, regulatory compliance, and responsible resource utilization. Every day, you will meticulously review medi
Christus HealthDescription Summary: The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective
We are searching for a Care Coordinator – someone utilizing a collaborative approach to assess, plan, implement, monitor and evaluate the options and services required to meet an individual's health needs. Provides comprehensive on-going case management services to patients by coordinating and manag
Job Description *Note: Candidates must be RN licensed in Massachusetts. Job Summary The Clinical Reviewer is a licensed professional –a Registered Nurse preferred– that is expected to function independently in her / his role and is responsible for managing a clinically complex caseload of varied req
A leading health organization is seeking a Utilization Management / Medical Management Nurse to work virtually from Texas. The role involves reviewing complex clinical cases to assess medical necessity, collaborating with healthcare providers, and providing nursing consultation. Candidates must hold
Spectrum Review ServicesSpectrum Review Services is looking for a qualified Utilization Review Coordinator to join our team. The applicant must have a current Texas Nursing License (RN or LVN). The applicant must be polite and have good phone etiquette. The applicant must be computer literate and must be organized and a se
Utilization Management Representative (UMR) ?? Pearland, TX (Onsite - 11511 Shadow Creek Parkway) ?? Full-Time | 24-40 hours/week | Monday-Friday, 8:00 AM - 5:00 PM Why This Role Matters Join a mission-driven healthcare team where your work directly impacts patient care, provider experience, and ope
A company is looking for a Utilization Review Specialist. Key Responsibilities Complete preadmission and concurrent reviews to obtain treatment authorizations and ensure ongoing communication with payors Coordinate peer reviews and manage the provision of Letters of Medical Necessity as needed Suppo
JOB DESCRIPTION At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, he
Texas Children's Hospital*Job Duties & Responsibilities** Serves as support to Medical Management Intake Department Primarily responsible for processing initial incoming faxes or phone requests into the intake department Gathering demographic and benefit data and documenting in appropriate system. This is determined thr
Responsibilities Utilization Management Coordinator -PRN Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adul
A company is looking for a Supervisor, Utilization Management RN. Key Responsibilities Oversee the implementation of care management review processes consistent with industry standards Manage care management reviews according to established criteria and clinical guidelines Facilitate collaboration a
PRIMARY RESPONSIBILITIES • Lead and manage offshore crane service operations, including direct oversight of offshore technicians and a Field Service Supervisor. • Establish departmental goals, KPIs, and performance standards aligned with business objectives, including revenue, margin, utilization, s
Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, thr
$40,000 – $63,000/year
Estimation confidence: Low
Estimate based on market data for Houston. Actual salaries may vary depending on experience, company, and area.
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