Top 27 Utilization review Jobs in Conroe Tx

Part-time ED Social Worker (Tuesday through Thursday from 1 to 9 p.m.
Memorial Hermann Health System —The Woodlands, TX
- Full-time
- Master of Social Work
- Mid-level
- Analysis skills
Staff Nurse Outpatient Clinic PHP/IOP CCC
Carrus Health —Conroe, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
11d
Case Manager / RN (PRN)
Houston Methodist Willowbrook Hospital —Houston, TX
- PRN
- Nursing
- Microsoft Excel
- Microsoft Outlook
11d
Staff Nurse Outpatient Clinic PHP/IOP CCTB
Carrus Health —Tomball, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
1d
Staff Nurse Outpatient Clinic PHP/IOP CCKW
Carrus Health —Kingwood, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
RN Case Manager
Nexus Children's Hospital —Shenandoah, TX
- Full-time
- Nursing
- RN License
- Bachelor of Science
Quick Apply
Clinical Director
ACES —The Woodlands, TX
- Full-time
- Word processing
- Clinic
- Children
- Continuing education credits
- Paid time off
Quick Apply
Clinical Supervisor – Substance Use & Behavioral Health Services
Elmhurst Home Inc —Spring, TX
- Full-time
- Remote
- LMFT
- Master of Social Work
- Management
- Health insurance
- Dental insurance
Quick Apply
MDS Coordinator - LVN/RN
Paradigm Northwest —Houston, TX
- Full-time
- Skilled nursing facility
- Microsoft Outlook
- LVN
- Health insurance
- Dental insurance
Quick Apply
9d
Board Certified Behavior Analyst (BCBA) - School District
All Care Therapies —Humble, TX
- $43 - $56 an hour
- Full-time
- HIPAA
- Psychology
- Mentoring
Quick Apply
Bilingual Nurse Case Manager
Suvida Healthcare —Houston, TX
- Full-time
- Hybrid work
- Spanish
- Nursing
- RN License
Quick Apply
Nurse Practitioner - N. Houston
Clay Consulting —Houston, TX
- $120,000 - $150,000 a year
- Extended hours
- Nursing
- Blood sampling
- Microsoft Excel
Quick Apply
11d
Full-time Occupational Therapist
North Houston Transitional Care —Houston, TX
- Full-time
- CPR Certification
- Management
- Doctoral degree
Quick Apply
PRN Occupational Therapist
North Houston Transitional Care —Houston, TX
- Part-time
- CPR Certification
- Management
- Doctoral degree
Quick Apply
Director of Nursing
North Houston Transitional Care —Houston, TX
- Full-time
- Nursing
- RN License
- Bachelor of Science
Quick Apply
2d
Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)
UT Health Science Center at San Antonio —United States
- Hospital
- Outpatient experience
- 3 years
Quick Apply
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance
Registered Nurse (RN) | Work from home | $34/hr | Starts 8/24/26
Carenet Health —United States
- $34 an hour
- Weekends as needed
- Remote
- Bilingual
- Nursing
- RN License
- Continuing education credits
- Paid holidays
9d

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utilization review jobs near conroe tx

Part-time ED Social Worker (Tuesday through Thursday from 1 to 9 p.m.

Memorial Hermann Health System -
The Woodlands, TX

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Job Details

Full-time

Qualifications

Master's degree in social work
Master of Social Work
Utilization review
Interdisciplinary collaboration in health services social work
Managed care organization experience
LMSW
DSM-5
Welfare eligibility determination
Clinical social history assessment
ICD-10
Utilization management
Resource utilization in healthcare
Behavioral and mental health screening
Experience working with individuals with substance use disorders
Negotiation
Substance abuse services in social work

Full 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, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

The Licensed Master Social Worker systematically intervenes to provide clinical social work and complex discharge planning to patients and their families who have complex psychosocial needs, require assistance with eligibility determination for social programs and funding sources and qualify for community assistance from a variety of special funds and agencies. Under the supervision of a licensed clinical social worker, offer crisis intervention and/ or mental health assessment to patients and families with psychosocial needs and coordinates and facilitates the development of a multidisciplinary discharge plan of care for high-risk patient populations. This role will participate in an interdisciplinary team (including Physicians, Case Managers, Staff Nurses and other members of the care team) to provide services for individuals from at-risk population and ensure that psychosocial issues are attended to and treated as required across the continuum of care.Typically reports to the Manager or Director, Case Management.
Job Description

Minimum Qualification
Education: Graduate of an accredited Master of Social Work program (MSW)
Licenses/Certifications: Current license as a Master Social Worker (LMSW) in the state of Texas required; ACM certification from American Case Management Association (ACMA) preferred

Experience / Knowledge / Skills:

Field placement or internship in health services/health care provider experience
Acute inpatient hospital social work experience preferred
Effective oral and written communication skills
Working knowledge of DSM V and ICD-10 manuals
Demonstrates knowledge and skill in social work assessment and treatment of patients for mental health status and substance abuse screening
Excellent therapeutic communication and negotiation skills in interactions with patients, families, physicians and health care team colleagues
Strong analytical skills
Working knowledge and/or experience in utilization management, managed care, and payer issues
Exposure and/or experience in pre-acute and post-acute care, as well as, community resources
Ability to work independently, as well as, to develop collaborative relations with physicians, families, patients, interdisciplinary team and other community agencies
Effective oral and written communication skills

Principal Accountabilities

Assesses patient’s and family’s psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope.
As part of a multidisciplinary team, develop and carry out a treatment plan by the use of a clinical social work diagnoses, assessments, and treatment interventions.
Intervenes with patients and families regarding emotional, social, and financial consequences of illness and/or disability; accesses and mobilizes family/community resources to meet identified needs. Under supervision this may include short term individual, marital and family therapies as well as crisis intervention
Provides intervention in cases involving child abuse/neglect, domestic violence, guardianship (temporary/ permanent), institutional abuse, foster care, adoption, mental health placement, advance directives, adult/elderly abuse, child protection and sexual assault.
Serves as a resource person and provides counseling and intervention related to treatment decisions and end-of-life issues.
Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system.
Participates in discharge planning activities for complex patients, in order to ensure a timely discharge and to provide appropriate linkage with post-discharge care providers.
Deals with families exhibiting complex family dynamics that impact directly on patient care and discharge.
Communicates with clinical care team members regarding the discharge planning status of all patients referred by them.
Provides consultation to Case Managers when coordination with significant or intensive community resources is necessary to achieve desired treatment outcomes.
Receives referrals for complex patient problem resolution from Case Managers or clinical care team members.
Works in collaboration with the clinical and case management team members on transition planning and referrals to post acute care providers. Keeps clinical and case management team members up-to-date on the status of the post-acute provider acceptance and clearance for discharge.
Validates discharge criteria for patient and families and notifies clinical and case management team members of newly-identified resources or change in previously-identified resources.
Educates patient/family and physician regarding post-acute options and addresses issues of choice.
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Other duties as assigned.

Apply Now

Refine Your Search

utilization review jobs in conroe tx

Part-time ED Social Worker (Tuesday through Thursday from 1 to 9 p.m.

Staff Nurse Outpatient Clinic PHP/IOP CCC

Case Manager / RN (PRN)

Staff Nurse Outpatient Clinic PHP/IOP CCTB

Staff Nurse Outpatient Clinic PHP/IOP CCKW

RN Case Manager

Clinical Director

Clinical Supervisor – Substance Use & Behavioral Health Services

MDS Coordinator - LVN/RN

Board Certified Behavior Analyst (BCBA) - School District

Bilingual Nurse Case Manager

Nurse Practitioner - N. Houston

Full-time Occupational Therapist

PRN Occupational Therapist

Director of Nursing

Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)

Utilization Management Reviewer

Registered Nurse (RN) | Work from home | $34/hr | Starts 8/24/26

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