874 Case Manager Utilization Review jobs in Houston,TX

Certified Case Manager (CCM) - PRN - Houston, TX - $42-$55/hr

Encompass Health Rehabilitation Hospital The Vintage

Houston, TX 77066

$42-$55/hr

OnsiteUrgently HiringEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

Certified Case Manager (CCM)
Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling).
If licensure is required for one's discipline within the state, individual must hold an active license.
Must meet eligibility requirements for CCM® or ACM™ certification upon entry into this position OR within two years of entry into the position.
CCM® or ACM™ certification required OR must be obtained within two years of being placed in the Case Manager II position.
For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in those states whose minimum requirement for licensure or certification is a diploma rather than an Associate Degree.
For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor's degree and graduate degree is preferred.

SmartExplore AI is experimental.

New, Posted 11 hours ago

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Case Manager

Encompass Health Rehabilitation Hospital of Houston at The Medical Center

Houston, TX 77054

OnsiteEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling).
If licensure is required for one's discipline within the state, individual must hold an active license.
Must meet eligibility requirements for CCM® or ACM™ certification upon entry into this position OR within two years of entry into the position.
CCM® or ACM™ certification required OR must be obtained within two years of being placed in the Case Manager II position.
For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred.
A diploma is acceptable only in those states whose minimum requirement for licensure or certification is a diploma rather than an Associate Degree.
For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor's degree and graduate degree is preferred.

SmartExplore AI is experimental.

New, Posted 11 hours ago

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Certified Case Manager (CCM) - PRN - Houston, TX - $42-$55/hr

Encompass Health Rehabilitation Hospital The Vintage

Houston, TX 77069

$42-$55/hr

OnsiteUrgently HiringEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

Certified Case Manager (CCM)
Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling).
If licensure is required for one's discipline within the state, individual must hold an active license.
Must meet eligibility requirements for CCM® or ACM™ certification upon entry into this position OR within two years of entry into the position.
CCM® or ACM™ certification required OR must be obtained within two years of being placed in the Case Manager II position.
For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in those states whose minimum requirement for licensure or certification is a diploma rather than an Associate Degree.
For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor's degree and graduate degree is preferred.

SmartExplore AI is experimental.

New, Posted 16 hours ago

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Care Manager, LTSS (RN)

Molina Healthcare

Houston, TX 77001

$26.41-$51.49/hr

Onsite

RN
License must be active and unrestricted in state of practice
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law
At least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience
In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements)
25-40% estimated local travel may be required (based upon state/contractual requirements)
Ability to operate proactively and demonstrate detail-oriented work
Demonstrated knowledge of community resources
Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations
Ability to work independently, with minimal supervision and demonstrate self-motivation
Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations
Ability to develop and maintain professional relationships
Time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change
Problem-solving skills
Strong verbal and written communication skills
Microsoft Office suite/applicable software program(s) proficiency
In some states, must have at least one year of experience working directly with individuals with substance use disorders

SmartExplore AI is experimental.

New, Posted 14 hours ago

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Property Adjuster Specialist - Field CAT Claims

USAA

Houston, TX 77002

RemoteUrgently HiringHealth InsurancePaid Time OffRetirement Benefit

High School Diploma or General Equivalency Diploma.
2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
Advanced knowledge of estimating losses using Xactimate or similar tools and platforms.
Proficient knowledge of residential construction.
Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations.
Proficient negotiation, investigation, communication, and conflict resolution skills.
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills.
Ability to travel 50-75% of the year (local & non-local) and/or work catastrophe duty when needed.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
Successful completion of a job-related assessment may be required.

SmartExplore AI is experimental.

New, Posted 14 hours ago

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Telephonic Transition of Care Coach (LPC or LCSW) - MUST RESIDE IN TEXAS

Molina Healthcare

Houston, TX 77001

$26.41-$51.49/hr

OnsiteUrgently HiringHealth Insurance

The Texas licensed LPC or LCSW
Licensed behavioral health clinician to include: Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD). License must be active and unrestricted in state of practice.
At least 2 years experience in health care, with at least 1 year of experience in hospital discharge planning, care management or behavioral health setting, or equivalent combination of relevant education and experience.
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
Knowledge of or experience using the Care Transitions Intervention (CTI) or similar model.
Background in discharge planning and/or home health.
Demonstrated knowledge of community resources.
Preferred to be able to travel 40-50% local travel may be required (based upon state/contractual requirements).

SmartExplore AI is experimental.

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Clinical Manager

ChenMed

Houston, TX 77021

OnsiteUrgently Hiring

$238,832 - $341,189 Salary
The posted pay range represents the base hourly rate or base annual full-time salary for this position.
This position may also be eligible for a bonuses or commissions.

SmartExplore AI is experimental.

New, Posted 1 day ago

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Manager Suitability Review

Horace Mann

Stafford, TX 77477

$76,600-$106,450/yr

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Quality Manager

PVI Holdings

Pasadena, TX 77502

~ 33 min Onsite

10 years minimum industry experience
API Q1 / 6D knowledge and experience
High school diploma or GED equivalent
Must be able to travel and have a clear driving record in accordance with company driving guidelines.
Clear background check and drug/alcohol screening.
Travel: less than 40%
Lifting up to 50 pounds
Bending, stooping, walking, and/or ability to stand for up to 75% of shift.

SmartExplore AI is experimental.

New, Posted 9 hours ago

Store General Manager

Petco

Pearland, TX 77584

~ 30 min OnsiteFlexible ScheduleBilingual PreferredHealth InsurancePaid Time OffRetirement Benefit

3+ years of management experience (retail leadership preferred)
Strong people leadership, coaching, and talent development skills
Solid business, financial, and operational acumen
Excellent communication, problem-solving, and organizational abilities
A genuine passion for pets and customer service
High school diploma or GED preferred
Completion of Petco leadership development programs may be required for internal candidates
The General Manager is expected to be regularly present on the sales floor, leading by example and engaging with partners, customers, and pets
Ability to safely lift and move merchandise, supplies, or animals weighing up to 50 pounds
Must be able to work in proximity to animals, including exposure to animal dander, odors, noises, and cleaning chemicals
Flexible availability to support Pet Care Center operating hours, including evenings, weekends, and holidays
This is a full-time position
A limited amount of travel may be required for training, meetings, or community engagement

SmartExplore AI is experimental.