RN Utilization Review Coordinator - Hybrid Case Management
Surgery Partners Brand
Surgery Partners Brand seeks an RN Utilization Review Coordinator for Methodist Hospital for Surgery in Addison, TX. This full-time, hybrid role supports prospective, concurrent, and post-discharge reviews to ensure medical necessity and payer compliance.
The successful candidate will collaborate with physicians and the Case Management team, manage denials, and contribute to discharge planning and quality improvement initiatives. A Texas RN license and five years in case management are preferred.
#J-18808-Ljbffr- Job Category : Managed Care Requisition Number : RNMAN035973 Posted : October 15, 2026 Full... ...TX 75001, USA Description Hiring Now for RN Utilization Review Coordinator Department: Case Management Shift: Full-time Hybrid Job Summary: The RN Case Manager/Utilization...SuggestedFull timeLocal areaShift work
- Methodist Hospital for Surgery in Addison, TX is seeking an RN Utilization Review Coordinator in the Case Management department. The role performs prospective, concurrent, and post-discharge reviews to ensure medical necessity and regulatory compliance. You will collaborate...Suggested
- ...Care Management NurseLocation: Parkland Support Serv... ...This position will hybrid- must be okay with coming... ...set related to utilization review, care coordination, performance improvement... ...have current, valid RN license or temporary... ...team to develop a case management plan of...SuggestedTemporary workMonday to FridayShift work
- ...Healthcare Reimbursement With Your RN Expertise ERISA Recovery is seeking... ...Nurse (RN) with a strong background in utilization management, clinical review, and denial appeals to join our... ...necessity reviews (inpatient & outpatient cases) Develop and submit high-quality...SuggestedRelocation
- ...SummaryThe Surgical Assistant -Coordinator plays a critical role... ...-paced environment, manages complex logistics with... ...complete and accurate case details.· Be main... ...on case volume, utilization, and cancellation trends... ...scheduling team in collecting, reviewing, and verifying patient...SuggestedFull timeWork at officeRemote work
- ...requirementsThe Heart Failure/VAD Coordinator is a registered nurse who... ...process. This will include Case Management duties as required.What You Will... ...24 months of hireCurrent RN license in the State of TX or... ...opening. Our team will promptly review your application. Highly...Full timeTemporary workMonday to FridayFlexible hoursDay shift
- ...North has immediate openings for an MDS Coordinator (RN) + $1,000.00 SIGN ON BONUS. Shift:... ...meetings and weekly Medicare meetings Reviews nursing documentation of residents and... ...guidelines Responsible for completing case management to ensure adequate documentation for reimbursement...Work at officeImmediate startRelocation packageMonday to FridayShift work
$41.6k - $47.84k
## Impound Coordinator - Hybrid - Dallas, TexasApply: Dallas, TX (TX143): Full... ...assets will be completed by utilizing our proprietary systems and... ...travel.**Job Responsibilities*** Review documents impound notices... ...with state; local laws* Manage the repossession process for...Full timeLocal areaRemote workRelocation- ...Medical Center seeks a Registered Nurse for medical necessity Utilization Review in our Dallas facility. The role involves reviewing admissions... ...physicians and care teams. The ideal candidate has an active Texas RN license, 5 years of experience including clinical and...
- ...The University of Texas Southwestern Medical Center is seeking an Utilization Review RN to assess medical necessity for acute care services. You will review admissions, coordinate with physicians, and apply evidence-based guidelines to determine care levels and documentation...Shift work
- UT Southwestern Medical Center in Dallas seeks an experienced Utilization Review RN for weekend PRN shifts. You will conduct medical necessity reviews for acute care services and collaborate with physicians to determine appropriate levels of care. Strong knowledge of evidence...ReliefShift workWeekend work
- ...looking for a Provider Enrollment Coordinator to support the division in... ...insurance plans, network managed care contracting plans, and third... ...the payers. Role will be Hybrid format 3 days in office at 48... ...provider billing numbers. Utilizes templates or prepares correspondence...
- ..., engineers, architects, construction management staff, environmental, strategic communications... ...around the world. In the role of Utility EIT/Coordinator , we’ll count on you for:... ...management. Participate in the QA/QC review of plans, specifications, and cost estimates...Full timeWork at officeRelocation
$200k
...Services program office after review of the EDRP application... ...5, Appendix G6); OR In cases of graduates of foreign... ...in goal setting for managing complex client... ...of direct patient care RN experience. At least 2... ...Experience in patient coordination (case management, care...Permanent employmentTemporary workWork at officeImmediate start- ...Services program office after review of the EDRP application... ...5 - Appendix G6) OR In cases of graduates of foreign... ...in goal setting for managing complex client... ...of direct patient care RN experience -At least 2... ...-Experience in patient coordination (case management - care...Permanent employmentTemporary workWork at officeImmediate startRemote workMonday to Friday
- ...organization that invests in you as a RN Coordinator? At Medical City Plano, you... ...to process patient acuity utilizing critical thinking skills,... ...Participates in daily bed management meetings when working in the... ...Talent Acquisition team is reviewing applications for our RN...Temporary workWork at officeFlexible hoursShift work
- Nippon Express U.S.A., Inc. in Dallas, TX seeks an on-site/hybrid Administrative Support Specialist to assist daily... ...Supervisor. This role includes attendance tracking, timecard review, reporting, and coordinating staffing with agencies. You will support onboarding,...
$69k - $80k
...Description This is a full-time, hybrid position. The candidate must... ...-on workers’ compensation case management training. Join our... ...treating physicians/providers and utilize available resources to help create... ...Registrations: Active Registered Nurse (RN) license required. Must be in...Full timePart timeLocal areaHome officeFlexible hours- ...medical certification review for medical necessity... ...qualifications, resource utilization, national and local... ...an active unrestricted RN license in the State of... ...scope of Utilization Management. Uses knowledge of national... ...to physicians, care coordinators, physician offices and...Full timeReliefWork at officeLocal areaNight shiftWeekend work
- A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Remote jobFull time
- ...navigation. Role Summary You’ll coordinate end-to-end episodes of care—... .... You’ll deliver remote case management (pre-op through post-op), keep... ...records from provider offices for review and submission to appropriate... .... Required Qualifications RN (BSN or equivalent) with 5+ years...Work experience placementWork at officeRemote workWorldwideFlexible hoursAfternoon shift
$41.2 - $62.17 per hour
...Description: The Clinical Program Coordinator assesses, plans, implements... ...: Three years of relevant RN experience required. Previous... ...physicians andnurses and concurrently reviews that all care meets evidence-... .... If applying for a remote or hybrid role, this includes remote...Hourly payFull timeRemote workMonday to FridayShift workNight shiftWeekend work- ...community-based 911 mental health crises and case management referrals. This team is adjacent and... ...in the field. BioTel Paramedic Coordinator This position is for a Paramedic to... ...of handling complex clinical care utilizing independent judgment. Must be able...Contract workMonday to FridayShift work
- ...years experience in medical intake and/or care coordination; experience in relationship development and managed care. Licenses and Certifications (NLC) NURSING... ...with standards of care criteria as outlined in utilization. Tracks data regarding intakes and referral sources...Full timeImmediate start
- UT Southwestern Medical Center is seeking an Utilization Review RN for PRN weekend shifts to conduct medical necessity reviews for acute care. The role relies on evidence-based guidelines to determine appropriate levels of care and to support physicians and care teams in...ReliefShift workWeekend work
- ...Procedure Coordinator RNDepartment: Hematology Oncology Outpatient ClinicLocation... ...in direct patient care. Utilizes the nursing process in the... ...that allow the nurse to manage whatever environmental and system... ...: Registered Nurse-1N-RN Essential Current license to...Work experience placementMonday to FridayShift work
- ...Manager Of Case ManagementWe are seeking an experienced and dynamic Registered Nurse (RN) to lead our Case Management team, with a strong focus on Utilization Review. The Manager of Case Management will oversee... ...staff to improve care coordination and reduce unnecessary...Full time
$41.2 - $62.17 per hour
...Description: The RN Hospital Care Manager I delivers comprehensive... ..., adjusts, and coordinates care plans to address... ...accredited institution. Case Management... ...in case management, utilization review, value-based care, and... ...applying for a remote or hybrid role, this includes...Hourly payRemote work- ...Billee Technologies, Inc. is seeking a Utility Vendor Coordinator to oversee the enrollment and coordination of utility services for multifamily... ...properties in Dallas, Texas. In this role, you'll submit and manage service applications with utility providers, ensuring...
- ...Home Health Bilingual Staffing Coordinator Pursue your passion and... ...tuition reimbursement, and a hybrid or blended work arrangement (... ...experience. Collaborate with Clinical Manager to create new hire caseloads... ...therapy as well as providing case management for children up to...Work experience placementWork at officeImmediate startWork from home
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