RN Utilization Review Specialist
HUMBLE VASCULAR SURGICAL CENTER INC
HUMBLE VASCULAR SURGICAL CENTER INC in Addison, Texas, is seeking a dedicated RN Case Manager to oversee utilization reviews and discharge planning. The role involves ensuring compliance with medical necessity guidelines while collaborating with physicians and interdisciplinary teams. The ideal candidate will possess a Bachelor of Science in Nursing, an active RN license in Texas, and five years of relevant experience. Strong communication and critical thinking skills are essential for effectively managing patient care and achieving optimal outcomes. #J-18808-Ljbffr
- ...A healthcare organization in Texas is seeking an RN Utilization Review Coordinator to perform utilization reviews and ensure medical necessity compliance. The role involves collaborating with healthcare teams, managing denial appeals, and supporting discharge planning....SuggestedFull time
- ...Methodist Hospital for Surgery in Addison, Texas is seeking a qualified RN Case Manager for Utilization Review. The role involves conducting medical record reviews, ensuring compliance with regulations, and supporting discharge planning activities. The ideal candidate...Suggested
- ...RN Utilization Review Coordinator, Full-time Job Category: Managed Care Requisition Number: RNMAN035973 Full-Time On-site Methodist Hospital for Surgery 17101 Dallas Pkwy Addison, TX 75001, USA Job Details Description Hiring Now for RN Utilization Review...SuggestedFull timeLocal areaShift work
- A healthcare institution in Addison, TX seeks an experienced Registered Nurse (RN) to oversee the Case Management team focusing on Utilization Review. Responsibilities include managing departmental operations, ensuring compliance with regulations, and improving care coordination...SuggestedFull time
- ...seeks a qualified medical certification professional to conduct reviews for medical necessity. The role demands extensive nursing... ...based guidelines. You'll support both acute care and resource utilization, offering a unique opportunity to grow within a renowned healthcare...SuggestedRelief
- ...Description Conduct medical certification review for medical necessity for acute care... ...related to admission qualifications, resource utilization, national and local coverage... ...program and holds an active unrestricted RN license in the State of Texas Experience...Full timeReliefWork at officeLocal areaNight shift
- ...experience and 2 years of ECMO specialist experience ~... ...(CCRN) CERT CRITICAL CARE RN (E-AEC) ELSO Adult ECMO Practitioner... ...needs and expectations and utilizes these in conjunction with the... ...family participation in care. Reviews personalized patient plan of...Hourly payFull timeShift workNight shift
- About the Role: Bracane Company is seeking a dedicated and detail-oriented Utilization Review RN to join our team in Austin, TX. This is an exciting opportunity for a clinical professional to make a meaningful impact by ensuring patients receive the right care at the right...Full time
- 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...Full timeRemote work
$97.76k - $204.59k
...Advisory. KPMG is currently seeking a Senior Associate, SAP CRM, Utilities to join our Advisory Services practice. Responsibilities:... ...the design of optimized future-state workflows. • Coach and review work products of Analysts/Associates. • Act with integrity,...Full timeH1bLocal area- ...Utilization Review Registered Nurse Texas Institute for Surgery LL SURG - Dallas, TX 75231 Description The Utilization Review Registered... .... Licensure/Certification/Registration: Current RN license in the state of Texas required BLS required Must...
- ...career in employee benefits solutions. As a Utilization Review Nurse (UR Nurse) , you’ll play an... ...closely with intake staff, physicians, specialists, case managers, and other members of the... ...cases. Requirements Current, unrestricted RN license (State license required)....Full timeTemporary workSummer workWork at officeFlexible hours
$41 per hour
hireops is looking for a Remote Registered Nurse to evaluate medical necessity and review claims. Candidates must have a valid RN license in Texas or Illinois and must possess at least 3 years of clinical experience. This is a contract position for about 9 months, with...Remote jobHourly payContract work$30 per hour
...and fast-growing national infusion company seeking experienced RN to join our team. This is a perfect opportunity to join an upbeat... ...for this position is hourly plus tips. Summary: An iV Specialists key role is to ensure clients are provided with intravenous medication...Hourly payReliefShift work- A healthcare staffing agency is seeking a Review Nurse for a contract assignment starting immediately. The role involves medical record abstractions and overreads during the HEDIS survey, requiring a Registered Nurse or Licensed Practical Nurse with experience in HEDIS...Contract workImmediate start
- ...Description BIM SPECIALIST This position can be based out of our offices in St. Louis MO,... ...support electrical construction initiatives, utilizing standard Company software, such as Revit... ...as needed. Consults with vendors and reviews project shop drawings for design accuracy...Contract workFor contractorsWork experience placementWork at officeRemote work
- ...Advisory. KPMG is currently seeking a Lead Specialist, Oracle Technical to join our Managed... ...lifecycle support, project reviews, and client delivery through timely and... ...interface and integration testing while utilizing ServiceNow for ticketing and documentation...Local area
- Position: Senior Hospice Revenue Cycle Specialist Location: Addison, TX Job Id: 231 # of... ...hospice and palliative care organizations utilizing the Curantis platform—managing NOEs,... ...Functions Claims & Payment Processing Create, review, and submit accurate hospice claims (UB-...Work experience placementWork at officeRemote workFlexible hoursShift work
- HCA Healthcare is seeking a Revenue Integrity Charge Review Analyst based in Texas. The position will require up to 60% travel and focuses on identifying variations in daily charges across multiple hospital departments. Responsibilities include conducting charge audits...Remote job
- Huntington Bank is looking for an SBA Eligibility Review Officer I in Dallas, TX. This role involves reviewing SBA & USDA guaranteed business loans, maintaining an individual pipeline of work, and ensuring loans close in compliance with eligibility requirements. The ideal...Work at officeRemote work
- ...acting as a patient advocate and delivering comprehensive care across all patient demographics. The ideal candidate will have Texas RN licensure, BLS and ACLS certifications, and at least two years of surgical floor experience. Essential functions include patient assessments...
- The Texas Department of Transportation seeks a highly motivated Utility Coordinator (I, II, or III) based in Dallas, Texas. This role supports transportation projects from design through construction, acting as a vital point of contact between TxDOT, utility companies,...
- ...Job Summary Position: CDI Quality Review RN - (948267). The CDI Quality Review Nurse (QRN... ...address the opportunity, as applicable. Utilize methodology-specific risk calculators and... ...(RN) upon hire. Clinical Documentation Specialist (CCDS) or Certified Clinical Documentation...Full timeRemote work
- ...rewarding career! Job Summary The CDI Quality Review Nurse (QRN) will work under the direction... ...experience Licenses and Certifications: RN (Registered Nurse) Upon Hire, (CCDS) Cert... ...review and address opportunity, as applicable Utilize methodology‑specific risk calculators and...Full timeRemote workShift work
- ...results-driven Construction Technology Specialist to join our team in Dallas, TX . The... ...culture, and operational standards. Utilize data visualization tools to manage historical... ...health assessments and drive continuous review of new technologies and software...For contractorsFor subcontractorWork at officeFlexible hours
- A leading utility services provider in Dallas is seeking a Lead Utility Notification Technician to lead a team of Notifiers. Responsibilities include managing communications with stakeholders and ensuring accurate notification records. Applicants should have certifications...
- ...must reside in IL or TX Contract: 12/22/2025 to 03/31/2026 RN working in the insurance or managed care industry using medically... ...is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation...Full timeContract workRemote work
$39.24 - $58.87 per hour
Associate Acoustics & Noise Control Specialist Date: Jun 8, 2026 Location: Overland Park,... ...studies for new and modified facilities by reviewing applicable local, state, and federal... ...performance and work assignments. Ability to utilize audio/videoconferencing software tools...Full timePart timeWork experience placementWork at officeLocal areaRelocationVisa sponsorshipFlexible hours- ...industry seeking an **Associate Purchasing Specialist**to support purchasing activities to... ...purchasing workflow processes and system utilization.* Ability to work across multiple time zones... ...how DPR protects applicant data, please review our Privacy Policy. #J-18808-Ljbffr DPR...For contractorsWork at office
- ...organized, and detail-oriented Distribution Specialist to oversee all shipping, logistics,... ...Canadian/international shipments Prepare and review shipping documentation including BOLs,... ...to maximize efficiency and space utilization RMA & Order Management Oversee RMA (Return...
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