Top 21 Registered nurse case Jobs in Mexia, Tx

Clinical Review Nurse, RN
MotivHealth —Texas
- Full-time
- Remote
- RN License
- Mid-level
- 3 years
- Travel reimbursement
- Wellness program
Quick Apply
3d
TJJD Substance Abuse Counselor I - III (MCL)
Texas Department of Public Safety —Mart, TX
- $3,793.41 - $5,921.25 a month
- Overtime
- LMFT
- Doctoral degree
- Current TB test
- AD&D insurance
- Paid holidays
12d
Registered Nurse (RN) - Case Manager
Adaptive Home Health —Mexia, TX
- Weekends as needed
- RN License
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
PRN Hospice RN- Teague
Reliant at Home —Teague, TX
- PRN
- CPR Certification
- Nursing
- RN License
Quick Apply
Assistant Manager
Limestone Medical Center —Groesbeck, TX
- Full-time
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
14d
Travel Registered Nurse -ICU-Critical Care over *12,000 per month
Health Carousel —United States
- $3,060 - $4,122 a week
- Travel nursing
- Nursing
- Anatomy knowledge
- Vital signs
- Health insurance
- Dental insurance
Quick Apply
7d
Travel Tele RN Job in Burlington, IA
GIFTED Healthcare —United States
- $2,408.08 a week
- Overtime
- Bilingual
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
4d

Other jobs to consider

Find your next job by exploring related positions.

Registered Nurse (RN) - ICU / Critical Care NIGHTS $10K SignOn - Parkview Regional Hospital
Parkview Regional Medical Center —Mexia, TX
Current RN license in the state of practice or compact state required. Performs comprehensive assessments, including head-to-toe assessments, pain assessments,…
Quick Apply
7d
Substitute School Nurse
ESS Education —Blue Ridge, TX
You may have rights under U.S. state privacy laws, including to request access, correction, deletion, or limitation of your personal information.
Quick Apply

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Registered Nurse (RNCM)
Bella Care Hospice —Columbus, OH
Successful completion of RN license program. Good knowledge of MS Office and data entry. Implements current nursing practice following a patient assessment and…
$75,000 - $85,000 a year
Quick Apply
1d
Hospice RN Case Manager
Wexner Heritage Village - Zusman Hospice —Columbus, OH
Ohio driver’s license, current auto insurance and access to a car during working hours. Registered nurse (R.N.) in the state of Ohio.
$72,000 - $85,000 a year
Quick Apply
10d

Show more jobs in cities nearby

I want to receive the latest job alert for registered nurse case in mexia, tx

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

registered nurse case jobs near mexia, tx

Clinical Review Nurse, RN

MotivHealth -
Texas

Quick Apply

Job Details

Full-time
3 days ago

Benefits

Travel reimbursement
Wellness program
Health savings account
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Professional development assistance
Flexible schedule
Life insurance
Referral program
Retirement plan

Qualifications

RN License
Utilization management
Quality improvement
Resource utilization in healthcare
Acute care experience
Nurse Licensure Compact (NLC)

Full Job Description

The Clinical Review Nurse (RN) supports the organization’s care management function by conducting clinical reviews, ensuring appropriate utilization of medical services, and maintaining compliance with regulatory and plan-specific guidelines. This role bridges clinical expertise with administrative processes to promote quality, cost-effective healthcare outcomes for members.

This is a remote role open to candidates residing in Utah, Texas, or Arizona.

HOW YOU’LL MAKE AN IMPACT:

Clinical Review & Case Management

Perform prospective, concurrent, and retrospective medical necessity reviews for inpatient, outpatient, and ancillary services.
Apply evidence-based guidelines (e.g., MCG, InterQual) to determine medical necessity and appropriateness of care.
Collaborate with physicians, providers, and other healthcare professionals regarding clinical determinations.

Utilization Management

Ensure timely processing of pre-certification, prior authorization, and concurrent review requests.
Document clinical findings and review outcomes accurately within utilization management systems.
Identify potential quality-of-care issues and escalate appropriately.

Member Advocacy & Coordination

Support case management teams in coordinating care for members with complex health needs.
Assist in transitions of care to reduce unnecessary readmissions.
Provide education to members and providers on coverage, benefits, and clinical guidelines.

Compliance & Quality

Ensure adherence to regulatory requirements (state, federal, ERISA) and accreditation standards (URAC, NCQA, etc.).
Maintain confidentiality of Protected Health Information (PHI) in compliance with HIPAA.
Participate in audits, quality improvement initiatives, and staff training.

WHAT YOU BRING:

A Current, unrestricted Registered Nurse (RN) license for Utah or compact license.
Minimum 3+ years of clinical experience(acute care, utilization review, or case management preferred).
Prior Utilization Management experience in a TPA or health plan setting strongly desired
Working knowledge of medical necessity criteria (MCG, InterQual) preferred.
Familiarity with ERISA, DOL, and state/federal regulations governing TPA operations a plus.
Strong clinical assessment, critical thinking, and decision-making skills.
Excellent written and verbal communication skills.
Proficiency in EMR/UM software and Microsoft Office Suite.

HOW WE SUPPORT YOU:

5% annual bonus based on company profitability
Affordable health, vision, and dental insurance for you and your family
Company contributes up to $2,300 to Health Savings Account annually
Wellness program that contributes additional money towards your HSA
Automatic 3% contribution into retirement plan
Career development and growth opportunities
15 days paid time off & 10 paid holidays per year

MotivHealth is a dynamic and mission-driven health insurance company dedicated to disrupting the status quo by making healthcare simpler and more affordable for our members. We believe in empowering our members to take control of their health and financial well-being. Our innovative approach requires a team of passionate, talented individuals who aren't afraid to challenge conventional thinking and build solutions that truly make a difference. If you're looking to contribute your skills to a company that values innovation and positive impact, MotivHealth is the place for you.

Job Type: Full-time

Benefits:

401(k)
401(k) matching
Dental insurance
Disability insurance
Employee assistance program
Flexible schedule
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Professional development assistance
Referral program
Retirement plan
Travel reimbursement
Vision insurance

Experience:

Utilization management: 3 years (Required)

License/Certification:

Registered Nurse License (Required)

Work Location: Remote

Quick Apply

Refine Your Search

registered nurse case jobs in mexia, tx

Clinical Review Nurse, RN

TJJD Substance Abuse Counselor I - III (MCL)

Registered Nurse (RN) - Case Manager

PRN Hospice RN- Teague

Assistant Manager

Travel Registered Nurse -ICU-Critical Care over *12,000 per month

Travel Tele RN Job in Burlington, IA

Other jobs to consider

Explore jobs in cities nearby

I want to receive the latest job alert for registered nurse case in mexia, tx

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected