Utilization review nurse jobs in Azle, TX - 206 jobs

PRN Utilization Review RN - M-F Days - (898817) Description PRN Utilization Review RN - Monday - Friday DaysWHY UT SOUTHWESTERN?With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U. S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! JOB SUMMARYConduct medical certification review for medical necessity for acute care facility and services. Use nationally recognized, evidence-based guidelines approved by medical staff to recommend level of care to the physician and serve as a resource to the medical staff on issues related to admission qualifications, resource utilization, national and local coverage determinations and documentation requirements. BENEFITSUT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:PPO medical plan, available day one at no cost for full-time employee-only coverage100% coverage for preventive healthcare-no copay Paid Time Off, available day one Retirement Programs through the Teacher Retirement System of Texas (TRS) Paid Parental Leave BenefitWellness programs Tuition ReimbursementPublic Service Loan Forgiveness (PSLF) Qualified EmployerLearn more about these and other UTSW employee benefits!EXPERIENCE AND EDUCATIONRequiredEducationGraduate of accredited nursing program and holds an active unrestricted RN license in the State of Texas Experience5 years experience to include 2 years of clinical experience and minimum of 3 years of recent utilization review experience. and Prior experience with Epic CCM. Licenses and Certifications(RN) REGISTERED NURSE Holds an active unrestricted license in the State of Texas. and PreferredExperienceAcute care experience preferred JOB DUTIESCollaborates with the Central Scheduling Department (CSD) team to provide accurate and complete clinical information in order to obtain authorization. Conducts admission reviews for Medicare and Medicaid beneficiaries as well as private insurance members and self-pay patients utilizing evidence-based guidelines. New admission reviews are done concurrently at the point of entry when the admission order is placed and necessary clinical information is available in the medical record. Communicate with admitting physicians and physician advisors when documentation does not appear to support hospital level of care. Use hospital approved medical necessity tool to determine level of care for inpatient or observation/outpatient services based on physician documentation, H&P, treatment plan, potential risks, and basis for expectation of a two-midnight stay. Keeps current on all Federal, State and local regulatory changes that affect delivery or reimbursement of acute care services within the scope of Utilization Management. Uses knowledge of national and local coverage determinations to appropriately advise physicians. Proactively collaborates with admitting physician to provide accurate level of care determination at the time of review. Escalates identified progression-of-care/patient flow barriers to appropriate departments. Actively participates in daily huddles, departmental meetingsand education offerings. Identifies and records episodes of preventable delays or avoidable days due to failure of progression-of-care processes. Educates members of the patient's care team on the appropriate access to and use of various levels of care. Promotes use of evidence-based protocols and/or order sets to influence high-quality and cost-effective care. Serves as a resource person to physicians, care coordinators, physician offices and billing office for coverage and compliance issues. Completes all reviews within department established policies and best practice standards. Meets department quality standards as established for the department, ie: Inter-rater Reliability audits, completing all initial reviews within established time frames, completes concurrent and discharge reviews to meet department and industry standards. Performs other duties as assigned. SECURITY AND EEO STATEMENTSecurityThis position is security-sensitive and subject to Texas Education Code 51. 215, which authorizes UT Southwestern to obtain criminal history record information. EEOUT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. Primary Location: Texas-Dallas-5323 Harry Hines BlvdWork Locations: 5323 Harry Hines Blvd 5323 Harry Hines Blvd Dallas 75390Job: NursingOrganization: 844107 - Utilization ManagementSchedule: Per Diem - PRNShift: Day JobEmployee Status: RegularJob Type: StandardJob Posting: Jan 5, 2026, 4:12:05 PM

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. JOB RESPONSIBILITIES: This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance to contract guidelines. Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities. JOB QUALIFICATIONS (Required): Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations. 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company. Knowledge of medical terminology and procedures. Verbal and written communication skills. JOB QUALIFICATIONS (Preferred): MCG or InterQual experience Utilization management experience LOCATION: REMOTE in Texas ( Richardson area - Dallas/Collin Counties). POSITION: 6-month assignment

About us: Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities The Utilization Review Nurse's duties will include, but are not limited to: Support internal claims adjusting staff in the review of workers' compensation claims Review records and requests for UR, which may arrive via mail, e-mail, fax, or phone Meet required decision-making timeframes Clearly document all communication and decision-making within our insurance software system Establish collaborative relationships and work as an intermediary between clients, patients, employers, providers, and attorneys Utilize good clinical judgment, careful listening, and critical thinking and assessment skills Track ongoing status of all UR activity so that appropriate turn-around times are met Maintain organized files containing clinical documentation of interactions with all parties of every claim Send appropriate letters on each completed UR Qualifications Active Licensed Practical Nurse and/or Registered Nurse License 1+ years of utilization review experience at a managed care plan or provider organization 2 + years' clinical experience preferably in case management, rehabilitation, orthopedics, or utilization review Excellent oral and written communication skills, including outstanding phone presence Strong interpersonal and conflict resolution skills Experience in a fast-paced, multi-faceted environment The ability to set priorities and work both autonomously and as a team member Well-developed time-management and organization skills Excellent analytical skills Working knowledge of: Microsoft Word, Excel, and Outlook

Job Description The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. . ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collects supporting data and analyzes information to make decisions regarding accuracy of billing Appropriately documents work and final conclusions in designated computer program Understanding of Surgical Implants Meets department's expectations and standards Additional duties as assigned KNOWLEDGE & SKILLS: Understanding of Itemization Review for designated clients Understanding of CERIS systems and Data Base informatics Understanding of HIPAA regulations Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment Strategic problem solving, analytical, and critical thinking skills Effective written and verbal communication skills Ability to work independently and within a team environment Proficiency with Microsoft Office Suite, including Excel, Outlook, Teams EDUCATION & EXPERIENCE: Must maintain current licensure as a Registered Nurse in the state of employment Must have a minimum of 5 years' experience in the O.R., ICU, or E.R. as an R.N. Associate Degree in Nursing or higher Experience in medical bill auditing preferred but not mandatory PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 - $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CERIS: CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or pharmacy benefit experience. Strong Excel/data analytics background preferred. Understanding of clinical guidelines and P&T processes. Why Join Us? Join a top-tier managed care team Hybrid flexibility Strategic and data-driven focus

Experience the My Health My Resources of Tarrant County (MHMR) difference, where we are united under one purpose, to bring wholehearted, life-energizing care to as many people as possible - on their own terms. And that starts with compassionate people like YOU! When you join the MHMR team, you will feel appreciated, recognized, and rewarded for the comforting, life-affirming care that comes right from your heart! Come join our team and experience the most rewarding career of your life! As the Utilization Management Reviewer supports daily operations by tracking authorizations, researching issues, coordinating with third-party payors, outside agencies, and clinics, processing discharges, and handling additional tasks to ensure optimal departmental performance. This role requires considerable independent initiative and judgment, serving as a resource to upper management with occasional travel. The reviewer has decision-making authority in program planning, policy development, and coordination of Medicaid and non-Medicaid service programs. Participation in regular meetings to strategize increasing system capacity is also included. Minimum Education: Bachelor's Degree Defined Education: Psychology, Sociology, or Social Work Preferences: None Substitutions: None Years' Experience: One (1) year Defined Experience: Direct Care License/Certifications: Qualified Mental Health Professional (QMHP) OR eligible for QMHP certification; Valid Texas Driver's License Why join us:MHMR has proudly served Tarrant and adjacent county residents for over 50 years. As the second largest mental health community center in Texas, we are dedicated to serving adults and children living with mental illness, substance use disorder and intellectual and developmental disabilities and delays and empowering them to improve their lives through an accessible, integrated, comprehensive person-centered system of care.MHMR is a mission-driven organization that fosters a culture of caring for employees and the people we serve. Our mission statement is We Change Lives. WeCARE: WeConnectPeople in Our Community We ProvideAccessto Services We Link People to Resources WeEmpowerPeople Our values are based on the following beliefs: Respect for people who are active in planning their services Recovery is a life-long process of better health Success as positive outcomes for each person Participation of people and their families in the process Inclusion in the community through services that promote growth and independence Safe, ethical, and cost-effective services Best practices in current research in medical, psychosocial and organizational fields Collaboration with other organizations for better services Compassion, trauma-informed care, and safety practices including suicide safe care. Benefits: MHMR offers an excellent benefits package that includes a retirement plan with company matching, generous PTO accrual, ten paid holidays, employee assistance programs, wellness programs, and more. MHMR is a participant in the Student Loan Forgiveness Program. We workdiligently to provide excellent benefits to employees and their eligible dependents. MHMR offers maximum compensation for each position's requirements based on candidates' education, experience, and internal equity of the agency. This practice reduces potential for biases in compensation and assists hires and/or promotions on pay equity in their appropriate position(s) at MHMR. For a complete Job Description, detailed qualifications and to apply please contact ********************* Minimum Requirements n/a

Your Job: The Nurse Practitioner participates in clinical, educational and research opportunities as an employee of Methodist Medical Group. Primary client base will be a patient referred for outpatient care. Your Job Requirements: • Completion of post-basic course of study through an accredited Physician Assistant Program or completion of Adult, Critical Care or Family Nurse Practitioner program. • Ability to learn new surgical techniques and medical skills as a physician extender. • Currently licensed or certified as a Physician Assistant or as a Nurse Practitioner. Your Job Responsibilities: • The NP/PA, working with a multidisciplinary team, manages all aspects of care of Cardiology perform necessary procedures for their care. • Obtains detailed history and performs physical examinations. • Performs or orders x-rays, electrocardiograms, stress tests, laboratory tests, and other diagnostic procedures, and interprets results. • Instructs patients on prescribed therapeutic regimens, home care and health maintenance. • Maintains required records and writes progress notes on patient charts as to status, treatments and procedures. • Provides follow-up and health maintenance care to patients in accordance with protocols established by physicians. • Enrolls patients in treatment programs and follows them throughout treatment phase. • Medically manages patient's complications and response to treatment Methodist Medical Group is the North Texas physician organization affiliated with Methodist Health System. Our fast-growing network of providers includes more than 60 healthcare clinics, an urgent care clinic, and a virtual care service known as MethodistNOW. Our employees enjoy not only competitive salaries but also the outstanding benefits package of Methodist Health System, which includes medical, dental, and vision insurance; a matched retirement plan; an employee wellness program; and more. The opportunities for career growth are equally generous. Our affiliation means being part of an award-winning workplace: 150 Top Places to Work in Healthcare by Becker's Hospital Review , 2023 Top 10 Military Friendly Employer, Gold Designation, 2023 Top 10 Military Spouse Friendly Employer, 2023

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST. * This position will service members in different states; therefore Multi-State Licensure will be required. The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. How you will make an impact: * Ensures member access to services appropriate to their health needs. * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Negotiates rates of reimbursement, as applicable. * Assists in problem solving with providers, claims or service issues. * Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current, unrestricted RN license in applicable state(s) required. * Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences: * Certification as a Case Manager. * Ability to talk and type at the same time. * Demonstrate critical thinking skills when interacting with members. * Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly. * Ability to manage, review and respond to emails/instant messages in a timely fashion. * Minimum 2 years' experience in acute care setting. * Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. * Managed Care experience. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $76,944 to $126,408. Locations: Colorado; New York; New Jersey In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

$3000 Sign-On Bonus Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours: Monday - Friday 8:30 - 5 pm CST or MST. * This position will service members in different states; therefore, Multi-State Licensure will be required. The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. How you will make an impact: * Ensures member access to services appropriate to their health needs. * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Negotiates rates of reimbursement, as applicable. * Assists in problem solving with providers, claims or service issues. * Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current, unrestricted RN license in applicable state(s) required. * Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences: * Case Management experience is preferred. * Certification as a Case Manager is preferred. * Minimum 2 years' experience in acute care setting is preferred. * Managed Care experience is preferred. * Ability to talk and type at the same time is preferred. * Demonstrate critical thinking skills when interacting with members is preferred. * Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred. * Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $80,608 to $120,912. Locations: Colorado. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Licensed Nurse Care Coordinator (VMS #3083) Hourly Rate: $35.18 Shift: 08:00 - 17:00, 9 hours per day Join our dedicated healthcare team as a Licensed Nurse Care Coordinator and make a vital impact in patient care and health outcomes. In this role, you will be integral to managing high-risk, multi-morbidity patient populations within the CHRISTUS Health network, ensuring quality care, closing care gaps, and supporting preventive health initiatives. This onsite position provides an exciting opportunity to collaborate with healthcare providers and positively influence patient experiences and outcomes. Required Skills: Valid Texas RN/LVN license with verification via Nursys Minimum of 3 years' clinical or home health experience Strong knowledge of care coordination and quality improvement processes Excellent communication and interpersonal skills for telephonic outreach and provider support Ability to interpret and utilize healthcare reports and data Proficiency with electronic health records and telecommunication tools Commitment to patient confidentiality and ethical practices Nice to Have Skills: Experience with value-based care programs and quality performance metrics Familiarity with STAR ratings and CMS quality initiatives Bilingual skills to support diverse patient populations Knowledge of care transition protocols and medication adherence strategies Preferred Education and Experience: High school diploma or equivalent required; completion of LVN/LPN program preferred At least 3 years of clinical or home health experience in a similar setting Prior involvement in quality improvement initiatives or care management roles Other Requirements: Reside within Texas Willingness to work onsite at possible CHRISTUS locations Ability to participate in periodic training and meetings Certifications in CPR or other relevant healthcare credentials preferred Transportation and travel reimbursements available when applicable This is your chance to thrive in a fulfilling role with competitive pay, comprehensive benefits, and a supportive team dedicated to your professional growth. Take the next step in your healthcare career by applying today and help us deliver exceptional patient care while advancing your expertise! VHS is an Equal Opportunity Employer (“EEO”)/Protected Veterans/Individuals with Disabilities/E-Verify Employer and welcomes all to apply #LiveYourLife

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. CrossPoint Medical Managment, a company of Bridge Specialty Group is seeking a Nurse Case Manager to join our growing team in Dallas, TX! This Nurse Case Manager role involves coordinating care for injured workers, ensuring effective communication between medical providers, employees, and employers. How You Will Contribute: Communicate with Medical Provider(s), Employee(s) and the Employer(s) Conducting In person visits with Injured Workers at Medical office or Hospital Assist in establishing a Plan of Care for Employees within the bounds of WC Law and/or Benefit Plans Immediate involvement in catastrophic cases (Telephonic) Document activity/progress notes into CrossPoint's system Manage and assist with assignments with Independent Nurses/Vendor Partners on selected cases Licenses and Certifications: Nurses license CCM designation (certification in Case Management) (preferred) Skills & Experience to Be Successful: Occupational injury background (preferred) 3 or more years of experience in a similar position Exceptional telephone demeanor Ability to maintain a high level of confidentiality About Us: Bridge Specialty Group creates a more seamless way to connect the varying needs of our retail partners with the market clout and talents of our wholesale entities. Our more than 25 niche-focused brands reflect our deep experience and specialization in construction, general casualty, environmental liability, professional liability, health care, public entity, workers' comp, property and personal lines. With more than 50 locations and more than 2,000 team members throughout the United States and Europe, Bridge has access to more than 200 standard and excess & surplus lines carriers that support our $7+ billion premium book. Our focus is on bringing the power of collective size and specialty to the wholesale brokerage marketplace. Bridge Specialty Group - aligning risk with greater reach. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.

HJ Staffing is seeking a Licensed Nurse Care Coordinator where you will bridge the gap between healthcare providers and high-risk patient populations. In this role, you will lead telephonic outreach initiatives for members attributed to our Value-Based Contracts, supporting ACO and CIN network providers in achieving quality improvement goals. Your mission is to close quality care gaps, manage high-risk multi-morbidity patient populations, and improve long-term patient outcomes through preventive care strategies. What You Will Do Gap Closure & Quality Metrics: Identify open quality gaps and pull reports to monitor value-based care performance. Telephonic Outreach: Conduct proactive outreach to patients to close care gaps, address medication adherence, and facilitate improved star ratings. Provider Support: Partner with Primary Care Providers to assist patients in scheduling preventive screenings and necessary medical appointments. Health Education: Provide vital counseling and health education to patients and families using standardized protocols and materials. Care Transitions: Serve as a subject matter expert in care transitions and quality improvement initiatives. Stakeholder Communication: Maintain ongoing, collaborative communication with healthcare providers, practice managers, and network teams. What You Will Bring Education: High School Diploma or equivalent (Required - proof of diploma must be submitted upon application). License: Active and unencumbered LPN/LVN license in the State of Texas. Experience: Minimum of 3 years of clinical or home health experience. Technical Skills: Proficiency in EHR systems (Experience with Epic is a significant plus). Interpersonal Skills: Exceptional telephonic communication skills and the ability to educate patients on complex health management plans. Additional Details Work Environment: This is a 100% onsite position located in the heart of Irving, TX. Schedule: Typical Monday - Friday, 8:00 AM - 5:00 PM business hours. Organization: Join a not-for-profit health system that encompasses multiple hospitals and a health insurance plan. Why Join Us? This is a competitive role within a dynamic healthcare environment that values innovation and collaboration. You will have the opportunity to directly impact the quality of care for vulnerable populations while growing your expertise in population health and value-based care models.

Our affiliate, Unified Women's Healthcare of Texas, is looking for a Nurse Practitioner to join their prestigious Women's Health Care Center in Dallas, TX. Join a compassionate group who provide a team approach to patient care. Every member of our staff is focused on making the patient experience in our office individualized and meaningful. Position Highlights: • Join an established and successful practice that has served women in the Dallas Metro area for over 15 years. • Practice team consists of 1 physician along with a great support staff. • This is mainly a clinic only position and does not require any call, nights, or weekends. • Nurse practitioner will work with patients along with the physician and will assist with the management of the office when the physician may be out doing deliveries, surgeries, or on vacation. • Duties include seeing primarily gynecology patients, completing charting, calling back patients with labs, answering patient phone calls, patient education, sending prescriptions electronically or by phone, and administering medications. • Patient Census in Clinic: up to 20 per day. • Will perform and assist with some minimally invasive procedures that can be completed in the office, such as pap smears, endometrial biopsies, and IUD placements. • Will assist physician with scheduling patient appointments and surgical procedures at the Medical City-Dallas Hospital. Compensation/Benefits Highlights: • Competitive compensation • Paid time off • CME reimbursement annually + paid time off • Comprehensive health, dental, and vision • 401k with matching • Short- and long-term disability, company paid life insurance • Company paid malpractice coverage • Supportive and appreciative culture Requirements: • National Nurse Practitioner certification or ability to obtain • Unrestricted, active licensure in the State or ability to obtain • Current Unrestricted DEA License or ability to obtain • CPR, BLS, and NALS Certification or ability to obtain • Proficient in assessment and development of treatment plans • Ability to communicate with patients, team members and management staff • Ability to make care decisions based on the best medical practices without direct supervision or guidance by a physician • One year of full-time experience as a Nurse Practitioner is preferred

Are you a compassionate, dedicated Nurse Practitioner with a passion for primary care? Are you ready to make a real difference in the lives of patients across all life spans within a supportive, collaborative environment? If so, Baylor Scott & White Health is the place for you! We're seeking a primary care focused Nurse Practitioner to join our dynamic Primary Care Team in the heart of Ft.Worth, Texas. As a recognized leader in healthcare, we pride ourselves on providing exceptional, patient-centered care-backed by national accolades from U.S. News & World Report. Whether you're looking to grow your career or take it to the next level, this is a fantastic opportunity to join a highly respected healthcare system that truly values its providers. Why Baylor Scott & White Health? • Top-Ranked Care: Join a system that's consistently ranked among the best for patient care, innovation, and leadership. • Impactful Work: Your work will directly affect the health and well-being of families in the community. • Collaborative Team: Work alongside a network of professionals who share your commitment to high-quality, compassionate care. Your Role: Primary Care Nurse Practitioner As a Nurse Practitioner with a primary care focus, you'll provide exceptional care across all life spans and families in a thriving primary care setting. You'll assess, diagnose, treat, and educate patients while collaborating closely with a team of dedicated professionals to ensure comprehensive care and best outcomes. Key Responsibilities: • Knowledge of information and techniques needed to diagnose and treat human injuries, diseases, and deformities to include symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures. • Knowledge of practices, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions. • Verbal and written communication skills. • Interpersonal skills. • Critical thinking and complex problem-solving skills. • Skill in the use of computers and related software applications. • Ability to develop and implement comprehensive outcomes-based patient treatment plans. • Ability to counsel patients concerning medical and psychological/psychiatric conditions, treatment plans, and behavior modification. • Ability to interpret and evaluate laboratory and other diagnostic tests. • Texas RN licensure or RN licensure with compact privilege from a state that is party to the Nurse Licensure Compact for RNs and LVNs & Texas APRN. • Current license to practice as a Nurse Practitioner in the state of Texas. • Basic Life Support within 30 days of hire or transfer. • National Nurse Practitioner certification in area of specialty. Compensation based on experience • BENEFITS • Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: • Immediate eligibility for health and welfare benefits • 401(k) savings plan with dollar-for-dollar match up to 5% • Tuition Reimbursement • PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level Qualifications: Education: Graduate of an accredited Nurse Practitioner program. Certifications: Certified primary care Nurse Practitioner or Family Nurse Practitioner. Licensing: Current Texas Nurse Practitioner license (or ability to obtain one). CPR/BLS: Basic Life Support (BLS) certification within 30 days of hire.

Quintairos, Prieto, Wood & Boyer, P.A., a multi-office national firm has an immediate opening for a full-time Nurse Paralegal to work with our growing medical negligence practice in Dallas, TX Office. This is a full-time position, competitive salary and benefits package offered. The individual in this role primarily supports attorneys with a busy defense litigation practice with an emphasis on medical negligence. This is a hands-on position that involves working collaboratively with clients and employees of the firm. Responsibilities • Support legal team by requesting, analyzing and summarizing medical records for clients, attorneys and experts. • Conduct medical journal research via Internet or through local libraries. • Abstract medical records, organize and prepare both outline and narrative summaries of the records for internal use and for presentation to the client. • Analyze medical records and billings to evaluate the strengths and weaknesses of the medical evidence including pre-existing or co-existing medical conditions. Prepare case analysis. Identify issues, omissions and discrepancies. • Identify and provide information regarding medical experts and physicians; coordinate medical expert deposition preparation. • Assist attorneys with medical evidence preparation and organization for hearing or trial. • Compose and type document production including case analysis memoranda for attorneys, outline and narrative summaries, and chronologies of medical records, correspondence, and reports. • Compile data for exhibits. • Conduct preliminary legal research as necessary. • Other job related duties as assigned. Qualifications • Bachelor's Degree in Nursing required. Paralegal Certification preferred. • 6+ years as registered nurse. 2+ years of law firm consultant/paralegal experience preferred. • Proficient understanding and utilization of medical terminology, anatomical drawings, laboratory tests, and medications. Possess thorough understanding of medical condition to explain or illustrate a diagnosis. Proficient proofreading, redlining, and editing of documents. Must ensure accuracy, comprehension, and overall grammar and punctuation. • Has full understanding HIPPA compliance. Understands and complies with all other related regulatory mandates. • Research, analytical, organizational and critical thinking skills required. • Proficiency in MS Word, Excel, Power Point and Outlook and knowledge and application of legal research tools (Westlaw). • Superior written and oral communication skills; excellent interpersonal skills to communicate with court personnel, attorneys and their staff, clients, witnesses and outside vendors. #LI-AR1

Community Healthcare of Texas has provided Hospice and Palliative Care Services since 1996. Community Healthcare of Texas has cared for patients with serious and terminal illnesses throughout North Central Texas. Providing compassionate care for those living with an illness while supporting those caring for a loved one is the mission of Community Healthcare of Texas. Community Healthcare of Texas is currently recruiting for an Admission Nurse. $3,000 Sign-On Bonus POSITION SUMMARY Meet with patients and families to explain the scope of hospice services and coordinate admission of patients. ESSENTIAL FUNCTIONS Conducts consultations for admission of patient services, including education of hospice services to patients and their families. Completes thorough assessment of patient at the time of admission; establishes/arranges initial frequency of nursing visits, DME/RX needs, and assesses the need for bereavement, social work, chaplain, and volunteer services. Attends and reports to the Interdisciplinary Team regarding the patient. Completes paperwork and charting thoroughly and accurately according to Policy. May conduct nursing or 'tuck-in' visits. May train other admission staff on admission processes. May conduct supervisory visits on LVN or CNA staff. QUALIFICATIONS Must be a Registered Nurse in the state of Texas Hold a valid driver's license 1 year of nursing experience required Case Management experience required Strongly prefer 2+ years of experience in hospice case management Must have proficient computer skills and Microsoft Office suite experience BENEFITS Competitive Pay Generous Paid Time Off Programs Company-provided Life Insurance, Short- and Long-Term Disability Medical, Dental, Vision Flexible Spending Account and Health Savings Account Employee Assistance Program Retirement Savings Plan Mileage reimbursement for work-related travel Reasonable Accommodations Statement To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform essential functions.

Provides preventative health services to facilitate the student's optimal physical, mental, emotional and social growth and development. Identifies problems and disabilities and provides such services as case finding, health education, referring and care in order to help prevent serious health problems which would later be more difficult and costly to address. Supports the education process by working to assure the health of the students. Qualifications: Education/Certification: Qualified to practice as a licensed or registered nurse in the State of Texas and holds an unrestricted license. Certified in CPR or BLS (or obtain in the first 6 months) Experience: Minimum of one (1) year experience in public health nursing, community health nursing, school health nursing or pediatric nursing Required Knowledge, Skills, and Abilities (KSAs): Knowledge of principles and practices underlying the special field of school health. Knowledge of current trends in nursing and of literature in the fields of school health. Knowledge of organization and administration of other cooperating agencies. Knowledge of state and local laws relating to health and social issues. Ability to participate cooperatively in a program of school health nursing. Ability to exercise professional judgment in making decisions. Ability to communicate appropriately and effectively with students, parents, administrators, other school personnel, etc… Demonstrate a genuine interest in the student population and its health needs Responsibilities and Duties: Promotes and protects the optimal health status of school-age children Provides health assessments Obtains a health history Screens and evaluates findings of the deficit in vision, hearing, scoliosis, growth, etc. Observes the child for development and health patterns in making nursing assessments. Identifies abnormal health findings. Develops and implements a student health plan Interprets the health status of students to parents and school personnel. Initiates referral to parents, school personnel or community health resources for intervention, remediation and follow through. Utilizes existing health resources to provide appropriate care of students. Provides ongoing health counseling with students, parents, school personnel or health agencies. Maintains, evaluates and interprets cumulative health data to accommodate individual needs of students Plans and implements school health management protocols Participates in home visits to assess the family needs as related to the child's health. Develops procedures and provides for emergency nursing management for injuries/illnesses Promotes and assists in the control of communicable diseases. Provides health education and anticipatory guidance Provides direct health education, and health counseling to assist students and families in making decisions on health and lifestyles that affect health. Participates in health education directly and indirectly for the improvement of health by teaching persons to become more assertive health consumers and to assume greater responsibility for their own health. Counsels with students concerning problems such as pregnancy, sexually transmitted diseases and substance abuse in order to facilitate responsible decision-making practices. Serves as a resource person to the school staff members in health instruction. Coordinates school and community health activities and serves as a liaison health professional between the home, school and community. Acts as a resource person in promoting health careers. Engages in research and evaluation of school health services to act as a change agent for school health programs and school nursing practices. Provides consultation in the formation of health policies, goals and objectives for the school district. Where applicable, participates in the IEP plan development. Travel as required. Equipment Used: All equipment required to perform jobs duties and task previously described Physical / Environmental Factors: The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Responsive Education Solutions considers applicants for all positions without regards to race, color, national origin, age, religion, sex, marital status, veteran or military status, disability, or any other legally protected status. ResponsiveEd is an Equal Opportunity Employer. Salary: $100.00 per day

Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or pharmacy benefit experience. Strong Excel/data analytics background preferred. Understanding of clinical guidelines and P&T processes. Why Join Us? Join a top-tier managed care team Hybrid flexibility Strategic and data-driven focus

Join Our Team as a Licensed Nurse Care Coordinator \ 3083 - Make a Difference in Patient Care! Are you a dedicated Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) seeking an impactful role that combines clinical expertise with patient advocacy? As a Licensed Nurse Care Coordinator, you will play a vital part in delivering high-quality, patient-centered care within our innovative health system. This onsite position offers an exciting opportunity to support value-based care initiatives, improve health outcomes, and develop your career in a collaborative environment committed to excellence. What You'll Bring: Minimum of 3 years of clinical or home health experience in a healthcare setting. Valid Texas LVN/LPN license with current Nursys verification. Strong communication and interpersonal skills to support patient engagement and provider collaboration. Ability to identify care gaps, support quality improvement initiatives, and promote preventive healthcare. Proficiency in using digital tools for reporting and care coordination. Nice to Have Skills: Experience working within Accountable Care Organizations (ACO) or Clinical Integration Networks (CIN). Knowledge of healthcare quality metrics and Star rating systems. Bilingual abilities to enhance patient communication. Familiarity with care transitions and chronic disease management protocols. Preferred Education and Experience: Licensed Vocational or Practical Nurse certification with at least 3 years of clinical or home health care experience. Previous experience supporting value-based care programs preferred. Other Requirements: Reside in Texas and be available to work onsite in Irving, TX. Commitment to adhering to standard protocols and maintaining patient confidentiality. Ability to work Monday through Friday, with shift hours from 08:00 to 17:00. Position is temporary with potential for permanent placement. Hourly Pay Rate: $35.18. Shift Length: 9 hours per day. Bring your clinical expertise and compassionate approach to a team that values your contributions. Take the next step in your career by applying today and help us transform patient care through dedicated service and innovative practices. VHS is an Equal Opportunity Employer (“EEO”)/Protected Veterans/Individuals with Disabilities/E-Verify Employer and welcomes all to apply #LiveYourLife