RN Case Management Leader - Utilization Review
Methodist Hospital for Surgery
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. Candidates must have an RN license with a BSN and ideally hold a Case Management certification. This full-time position emphasizes effective communication, leadership, and critical thinking skills. #J-18808-Ljbffr Methodist Hospital for Surgery
- ...Job Title You supervise utilization review for RNs. You oversee processes daily. Guide on complex cases. Identify staff education opportunities. Connect departments through... ...'t meet criteria. Updating Clinical Resource Manager as needed. Assigning daily tasks to staff...SuggestedWork at office
- ...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...SuggestedFull timeLocal area
- ...Company is seeking a dedicated and detail-oriented Utilization Review RN to join our team in Austin, TX. This is an... ...prospective, and retrospective reviews of patient cases Collaborate with physicians, case managers, and healthcare teams to coordinate patient care...Suggested
$1,357 per week
...Registered Nurse (RN) | Utilization Review Location: Dallas, TX Agency: GQR Healthcare Pay: $1,357 per week Shift Information... ...Utilization Review RN in Dallas, Texas, 75230! Case Manager RN Job Location: Dallas, TX Profession: Registered...SuggestedHourly payWeekly payFull timeContract workImmediate startShift work$1,357 per week
...Registered Nurse (RN) | Utilization Review Location: Dallas, TX Agency: GQR Healthcare Pay: $1,357 per week Shift Information... ...13 Weeks Start Date: ASAP About the Position Case Manager RN Job Location: Dallas, TX Profession:...SuggestedHourly payWeekly payFull timeContract workImmediate startShift work- 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...
- A healthcare organization in Texas is seeking an RN Utilization Review Coordinator to perform utilization reviews and ensure medical necessity... .... The role involves collaborating with healthcare teams, managing denial appeals, and supporting discharge planning. Candidates...Full time
- ...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...
- Bracane Company in Austin, TX is seeking a dedicated Utilization Review RN to ensure patients receive the right care at the right time and to support care coordination with physicians and care teams. The ideal candidate holds an active Texas RN license with 2-3 years of...
- ...Description Build and Lead a Water Utility Infrastructure Practice —... ...firm to identify a senior leader who’s ready to build, lead,... ...culture Lead performance reviews and support employee development... ...mentor Engineers and Project Managers at all career stages Build...Contract workWork at officeLocal area
- A leading healthcare facility in Dallas is seeking an ACO RN Case Manager/Beneficiary Care Navigator. The role involves managing a caseload of patients with chronic conditions, ensuring timely healthcare coordination and positive outcomes. Ideal candidates will have a Bachelor...Full time
- ...Your Job: The Clinical Team Leader performs direct patient care... ...90 days of hire). • Current RN license in the State of Texas... ...from the unit. • Assists the manager in achieving and sustaining department... ...by Becker’s Hospital Review , 2023 ~ Top 10 Military Friendly...Shift 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
- Position Summary Department: Managed Services. This position will... .... Responsibilities Perform utilization review activities, including precertification... ...initial reviews to UM RN and determine medical... ...incoming patients. Prepare cases for Physician Advisor for 2nd...Work at officeRemote workRelocation package
- Utilization Review Nurse for Workers' Comp Job Purpose: Review Workers Compensation requests submitted... ..., when appropriate, or prepare a case for peer review referral. Coordinates information... ...of an accredited school Valid current RN license in good standing Able to perform...
$80k - $90k
Arc Hospice & Palliative Care in Dallas, Texas is seeking a full-time Hospice RN Case Manager. You will provide skilled nursing care to hospice patients, ensuring high-quality, compassionate care by collaborating with an interdisciplinary team. The ideal candidate should...Full time- ...come into their own as digital leaders. Ready to find genius answers... ...(.)You Are:A senior Oracle Utilities Integration Lead who brings both... ...artifacts.Establish and manage integration testing strategy... ...setting delivery standards, reviewing technical designs, and ensuring...Full timeWork experience placementLive inWork at officeLocal areaRemote work
- ...group of talented Discipline Leaders. The ICT Discipline Leader (DL... ...onboarding, and integration.Manage ICT staffing assignments in coordination... ...ICT resource forecasts, team utilization, and staff development.... ...check-ins and performance reviews; contribute to compensation,...Work at officeRemote work
- ...Manager Of Case Management We 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 the daily operations of the case management department...Full time
- ...Clinical Team Leader The Clinical Team Leader performs direct patient... ...and competencies, current RN license in the State of Texas... ...flow for the unit, assisting the manager in achieving and sustaining... ...Healthcare by Becker's Hospital Review, 2023 ~ Top 10 Military...Shift work
- ...Description : Your Job: The Clinical Team Leader performs direct patient care as the charge... ...within 90 days of hire). • Current RN license in the State of Texas or compact license... ...patients from the unit. • Assists the manager in achieving and sustaining department and...Shift workRotating shift
- ...Clinical Team Leader The Clinical Team Leader performs direct patient... ...and competencies, current RN license in the State of Texas... ...efficient patient flow, assisting the manager in achieving and sustaining... ...by Becker's Hospital Review, 2023 ~ Top 10 Military Friendly...Shift work
- ...the scenes in data science, case management or transfer centers. Unlock your... ...-up for your OR, including utilization of preference cards and ability... ...anesthesia Consistently review your charts for completeness,... ...ambulatory surgery center Active RN license as required by state...Full timeTemporary workPart timeFlexible hours
- ...according to acceptable standards of practice and company procedures. Review and approve patient information submitted by the licensed... ...Education and experience, preferred ~ Previous experience in management is preferred. Requirements Must possess a valid state...Full timeLocal areaFlexible hours
- ## RN Clinical Team Leader - Observation/Med Surg Unit - NightsApplylocations: Dallas, Texastime type... ...patients from the unit. • Assists the manager in achieving and sustaining department... ...in Healthcare by *Becker’s Hospital Review*, 2023* Top 10 Military Friendly Employer...Shift workNight shift
- ...Coordinator (CNC) to ensure and deliver high quality, patient-centered care across the unit during shifts. You will collaborate with the management team to monitor nursing care and support staff in achieving excellent clinical outcomes. The role requires active involvement in...Shift work
- ...fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment...Remote jobContract work
- ...FUNCTION The Registered Nurse, RN, is a member of the... ...care. JOB RESPONSIBILITIES a. Case Management and Supervision for Registered... ...RN, appropriately identifies/utilizes resources, referrals such as... ...personally and per Team Manager reviews b.Registered Nurse, RN, responsible...Full timeFlexible hoursShift workNight shiftRotating shiftWeekend workDay shiftAfternoon shiftWeekday work
$75k
...currently seeking an experienced RN Clinical Coordinator with... ...to the Senior Director of Utilization Management in the Utilization... ...include: Admit new clients by reviewing records and applications; conduct... ...and escort. Monitor cases by verifying clients' attendance...Full timeApprenticeshipWork experience placementWork at officeLocal areaRelocationMonday to FridayFlexible hoursDay shift- ...reside in IL or TX Contract: 12/22/2025 to 03/31/2026 RN working in the insurance or managed care industry using medically accepted criteria to validate... ...responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract...Full timeContract workRemote work
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