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
$70k - $100k
*Description* Methodist Surgery Center, part of the Surgery Partners network, is seeking an experienced Utilization Review Specialist to join its team in Addison, Texas. This position is ideal for someone with many years of experience doing Utilization Review who can quickly...SuggestedPermanent employmentRemote work2 days per week$16.74 - $26.92 per hour
...Utilization Review (Ur) Intake Specialist The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming telephone calls, supporting the...SuggestedHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours- ...About the Role The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level... ...behavioral health or chemical dependency setting. Licensure: Current RN, LCSW, or LPC license preferred. Skills and Competencies: In-...SuggestedFull timePart timeWeekend work
- A leading medical review organization is seeking Board-Certified physicians in Gastroenterology for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment. Candidates must have...SuggestedRemote workFlexible hours
- ...RN Utilization Review Coordinator The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post-discharge utilization reviews to ensure appropriate patient status, medical necessity, and compliance with hospital policy, payer...Full timeLocal area
- 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...Full time
- ...Utilization Review RN Are you seeking an impactful nursing role? As a Utilization Review RN, review cases to determine medical suitability for insured patients. Your expertise shines through meticulous clinical reviews using established criteria. You play a key role...ReliefLocal area
- Job Summary You supervise utilization review for RNs. You oversee processes daily. Guide on complex cases. Identify staff education opportunities. Connect departments through communication. Job Summary You supervise utilization review for RNs. You oversee processes daily...Work at office
- ...As a Mental Health Intake Specialist - RN, your voice to influence patient care is valued and... ...interventions within the Recovery Plan Utilize teaching skills related to psycho educational... ...Intake Specialist - RN opening. We review all applications. Qualified candidates...Temporary workImmediate startFlexible hours
- Baylor Scott & White Health in Dallas, TX seeks a supervisor to oversee Utilization Review for RNs and guide daily processes. The role focuses on complex case guidance, staff education opportunities, and interdepartmental communication to enhance care quality. Responsibilities...
- ...RN II - ECMO Specialist RN Team Lead (Nights) WHY UT SOUTHWESTERN? With over 75 years of excellence... ...'s family needs and expectations and utilizes these in conjunction with the assessment... ...patient/family participation in care. Reviews personalized patient plan of care with...Hourly payFull timeShift workNight shift
$90k - $100k
...from Principle Services, LLC Field Safety Specialist We are seeking a highly skilled and... ...operations, specifically within the Electric Utility Industry on Substation and Transmission... ...Support the development and review of safety plans, wire-pulling plans, site...Contract workFor contractorsWork at officeLocal areaRemote workFlexible hours- UT Southwestern Medical Center is seeking an Utilization Management Coordinator on a PRN basis with availability from 7am to 10pm. The role supports faxing initial, concurrent, and discharge reviews to insurance providers and documents information in EPIC. It involves handling...Relief
- EMPOWER - OASIS Review Coding Specialist job at EMPOWER. Richardson, TX. GENERAL PURPOSE Accurate and timely coding and review of home health... ...to overall quality improvement efforts, and manage visit utilization. ESSENTIAL FUNCTIONS Review and analyze OASIS assessments...
- 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
$40 per hour
...time remote Candidates must be based in TX. RN working in the insurance or managed care... ...for performing initial, concurrent review activities; discharge care coordination for... ...guidelines. Provides information regarding utilization management requirements and operational procedures...Remote jobFull timeContract workWork at office$125k - $182.5k
...Charge or Assistant Examiner-in-Charge, executing transaction reviews, secondary reviews of transactional testing completed by others... ..., external auditors and regulatory agencies.The Portfolio Specialist works together with the Credit Review Portfolio Manager(s) to...Full timeWork at officeFlexible hoursDay shift- Utilization Review Nurse for Workers' Comp Job Purpose: Review Workers Compensation requests submitted by the provider, requestor, claimant or... ...Qualifications: Graduate of an accredited school Valid current RN license in good standing Able to perform the professional and...
- HUMBLE VASCULAR SURGICAL CENTER INC is looking for an experienced Registered Nurse (RN) to manage the Case Management team with an emphasis on Utilization Review. This position requires a capable leader to oversee daily operations ensuring compliance and optimal patient...
- ...anesthesiologists, and care teams to evaluate patients, gather data, and determine clearance for procedures. Responsibilities include reviewing medical histories, coordinating preoperative testing, and educating patients on medications and preparation. #J-18808-Ljbffr Sca-...
- ...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...
- A leading healthcare system in Texas is seeking a Registered Nurse for the Operating Room. The RN will coordinate patient care and implement care plans while utilizing the Da Vinci Xi robotics system. Candidates must possess a BSN and at least 1 year of OR experience in...Full timeDay shift
- Cantex seeks a Vascular Access Registered Nurse to provide vascular access services across the Houston/Beaumont market. You will perform PIV, Midline, and PICC insertions with a focus on patient care, accurate documentation, and regulatory compliance. As the primary vascular...
$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- Assessment Specialist RN Schedule: Full time Nights Your experience matters Carrollton Springs is part of Lifepoint Health, a diversified... ...motivations, treatment planning and communication with external review organizations or comparable entities. Current, unencumbered...Full timeTemporary workPart timeNight shift
- Advanced Primary Care Practice Llc is seeking a Vascular Access RN to deliver PIV, Midline, and PICC insertions across the Houston/Beaumont market, ensuring safe patient care and accurate clinical documentation. The role requires an active Texas RN license, BLS certification...Relief
- Muir Home Health is seeking a Quality Assurance Registered Nurse (QA RN) to join our team in California. This role focuses on reviewing OASIS data integrity, ensuring accurate coding, and collaborating with clinicians to resolve documentation issues. The QA RN will participate...
- ...Utility Specialist - Single Family Rental Property Operations Dallas, TX Evergreen Residential is a high growth real estate company and institutional investment platform in the single-family residential ('SFR') and build-to-rent ("BTR") sectors. We are committed...Work at officeLocal areaFlexible hoursAfternoon shift
- JOB SUMMARY: Under direction, perform skilled maintenance, repairs and installations on utility related facilities. Perform preventive maintenance on electrical, electronic, plumbing, pumping, mechanical, and motor control systems. Perform other related work as required...Full timeWork at office
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