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Hca Utilization Review Jobs in Texas (NOW HIRING)

Methodist Hospital

Case Manager RN

Cibolo, TX · On-site

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our health ... Prefer at least one year experience in utilization review, resource management, discharge planning ...

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Hca Utilization Review information

What is an HCA Utilization Review?

An HCA Utilization Review job involves evaluating medical services to ensure they are necessary, cost-effective, and meet quality standards. Professionals in this role review patient records, coordinate with healthcare providers, and ensure treatments align with insurance guidelines and hospital policies. They play a key role in optimizing resource utilization, preventing unnecessary procedures, and ensuring compliance with regulations. Strong analytical skills and knowledge of medical terminology are essential for success in this position.

What does an HCA Utilization Review do?

In HCA Utilization Review, your day usually involves reviewing patient medical records, assessing the necessity and appropriateness of proposed treatments, and communicating decisions to physicians and case managers. You may also participate in interdisciplinary meetings, liaise with insurance providers for authorization, and document your findings in healthcare management systems. The role is collaborative, requiring you to interact with diverse medical and administrative teams to align patient care with policy guidelines. This blend of independent evaluation and team collaboration makes each day varied and impactful for patient outcomes.

What are the key skills and qualifications needed for an HCA Utilization Review?

To thrive as a HCA Utilization Review professional, you need a solid foundation in medical terminology, clinical assessment, and insurance guidelines, often supported by a healthcare-related degree or nursing license. Familiarity with utilization review software, electronic health records (EHR) systems, and certifications like CCM (Certified Case Manager) are highly beneficial. Excellent analytical thinking, attention to detail, and strong communication skills help you effectively evaluate patient records and collaborate with providers. These competencies are key to ensuring appropriate care utilization, supporting cost-effective treatment decisions, and maintaining regulatory compliance.

What are the most commonly searched types of Hca Utilization Review jobs in Texas?

The most popular types of Hca Utilization Review jobs in Texas are:

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For Hca Utilization Review jobs in Texas, the most frequently searched job titles are:

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Hca Utilization Review jobs near you
Infographic showing various Hca Utilization Review job openings in Texas as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

Case Manager RN PRN

Methodist Hospital Texsan

San Antonio, TX • On-site

Per diem

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Job description

Do you have the PRN career opportunities as a Case Manager RN PRN you want with your current employer? We have an exciting opportunity for you to join Methodist Hospital Texsan which is part of the nation's leading provider of healthcare services, HCA Healthcare.
This PRN position will be for weekday coverage *
Job Summary and Qualifications
As a Case Manager, your role will be to support patients and families through every step of their care journey. You will coordinate services, connect resources, and develop care plans that reflect each patient's unique needs. By partnering with physicians, nurses, and department leaders, you will help ensure safe transitions, clear communication, and consistent quality across the continuum of care.
Your responsibilities will include:
  • Guiding patients and families through program orientation, explaining the rehabilitation philosophy, Medicare and insurance benefits, discharge criteria, and patient rights
  • Coordinating education for patients, families, and caregivers to encourage participation in treatment planning, goal discussions, and family conferences
  • Developing and implementing individualized treatment plans that reflect the patient's strengths, needs, and personal recovery goals
  • Completing psychosocial assessments and discharge planning evaluations, clearly documenting findings and communicating needs across the care team
  • Collaborating closely with the Rehab Program Director, Facility Case Management Director, and interdisciplinary team to ensure seamless, patient-centered care
  • Promoting HCA Healthcare's values of compassion, respect, and excellence through every patient and family interaction

What qualifications you will need:
  • Graduate of an accredited diploma, associates, or baccalaureate degree nursing program. Preferred: Bachelor of Science in Nursing
  • RN License to practice as a professional registered nursing in the state of Texas or Active Multi-State RN Compact License. (Employees with RN Compact License are required to obtain Texas RN License within 90 days of hire date.)
  • Minimum of 3 years RN experience
  • Prefer one year experience in utilization review, resource management, discharge planning or case management.

Benefits
Methodist Hospital Texsan, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include some or all of the following:
  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location and position.
Methodist Hospital Texsan is a 120 bed acute care hospital. We remain one of South Texas's premier heart and orthopedic hospitals. We are certified in chest pain and heart failure with comprehensive cardiac services. Our orthopedic services, including the Joint Replacement Academy and the Center for Spine, hold some of the best clinical results in the industry. We achieve this by using state-of-the-art technology, such as our robotics program.
Methodist Hospital Texsan is the first hospital in San Antonio to receive the Joint Commission's Gold Seal of Approval for Chest Pain Certification. We were awarded the Heart Care Center National Distinction of Excellence. This is the highest recognition a hospital can receive. Our ICU was awarded the Silver Beacon Award for Excellence. We are also recognized as a Level IV trauma center. Our 30 bed Inpatient Rehab Unit has received the Rehabilitation Stroke Certification from the Joint Commission. Methodist Hospital Texsan has been deemed one of Modern Healthcare's Best Places to Work in Healthcare for 3 years in a row. We were a recipient of the 2019 Guardian of Excellence Award® by Press Ganey. Join our record setting team today!
"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Case Manager RN PRN opening. We review all applications. Qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status

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