Utilization Review RN: Medical Necessity & Care Level
The University of Texas Southwestern Medical Center
UT Southwestern Medical Center seeks a Registered Nurse for medical necessity Utilization Review in our Dallas facility. The role involves reviewing admissions, using evidence-based criteria, and advising on level of care with physicians and care teams. The ideal candidate has an active Texas RN license, 5 years of experience including clinical and utilization review, and familiarity with Epic CCM. Join a reputable academic medical center with strong benefits. #J-18808-Ljbffr The University of Texas Southwestern Medical Center
$2,150 per week
...is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in... ...DUTIES – Evaluate the medical necessity, appropriateness, and efficiency of patient care to ensure it meets clinical... ...facility of similar size and level as this facility ~ Epic...SuggestedTemporary workFor contractorsZero hours contractImmediate startShift work- UT Southwestern Medical Center in Dallas is seeking a Utilization Review Nurse (RN) to perform medical necessity reviews for acute care services on a PRN basis. Flexible availability Monday through... ...and private pay, and determine level of care using hospital-approved guidelines...SuggestedReliefMonday to FridayFlexible hours
- Position Summary: The RN Integrated Care Coordinator (UM)... ...required to address utilization review cases. Roles and Responsibilities... ...of cases involving medical decisions and... ...support the medical necessity review process and... ...including basic level CPT/ICD10, authorizations...SuggestedLive inRemote workFlexible hoursWeekday work
- RN Utilization Review CoordinatorThe RN Case Manager/Utilization Review is responsible... ...patient status, medical necessity, and compliance with hospital... ...through the episode of care. This position also assists... ...necessity and appropriate level of care throughout the episode...SuggestedFull timeLocal area
- ...Job Details - With level of care screening criteria such as MCG or Interqual... ...related to hospital admissions, Utilization management or utilization review, and interfacing with health care... ...to enjoy, including: ~ Medical, dental and vision benefits ~ Earned...SuggestedTemporary work
- ...Description Summary: The RN Navigator Home Health Review plays a crucial role in... ...member of the patient’s care team, the RN Navigator... ...(Plan of Care) based on Medical Necessity guidelines and Homebound... ...discharge from service. Utilizes MCG Guidelines for post-acute...Full timeWork at officeMonday to Friday
- ...Order Pharmacies, Medical Billing Centers,... ...Responsibilities: Conducts utilization management... ...certification reviews, facilitates the... ...determine appropriate level of care for utilization... ...for medical necessity (referring cases... ...! Qualifications RN License in NY with...Hourly payCasual workPrivate practiceWork at officeImmediate startMonday to Friday
- Baylor Scott & White Health is seeking an experienced Utilization Review RN to review cases for medical necessity across insured patients. You will apply clinical criteria, coordinate with care teams, and support efficient resource use. You will communicate with health...
- ...of Texas Southwestern Medical Center in Dallas is seeking a PRN Utilization Review Nurse to conduct medical necessity reviews for acute care. You will use evidence-... ...guidelines to recommend levels of care, serve as a resource... ...with an active Texas RN license and at least 5...Relief
- 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
$65 per hour
...Professionals accepted) Case Manager-RN - JOB TITLE (#25268): RN Case Manager | Utilization Review - Syracuse, NY Location: Acute Care|Academic Medical Center, Syracuse, NY Employment Type:... ...reviews for appropriate care level and coverage ~ Coordinate discharge planning...Hourly payFull timePrivate practiceMonday to FridayDay shift- ...Description Summary: The RN Navigator Home Health Review monitors home health patients... ...member of the patient’s care team and act as a patient... ...(Plan of Care) based on Medical Necessity guidelines and Homebound... ...discharge from service. Utilizes MCG Guidelines for Home Care...Full timeWork at office
- ...A leading healthcare staffing firm is seeking a Utilization Review RN in Syracuse, NY. The role involves conducting utilization management activities, certification reviews, and collaborating with healthcare providers. Candidates must have an RN License in NY and at least...Monday to Friday
$2,550 - $2,630 per week
...Description Job Description RN – Utilization Review Location: East Elmhurst, NY 113... ...evaluate healthcare services and medical records for medical necessity, appropriateness, and compliance... ...collaborate effectively with providers, care management teams, and other...Hourly payContract workLocal area- ...Addison, TX seeks an experienced Registered Nurse (RN) to oversee the Case Management team focusing on Utilization Review. Responsibilities include managing departmental... ...compliance with regulations, and improving care coordination. Candidates must have an RN license...Full time
$35 - $45.94 per hour
...Oscar. We're hiring a Utilization Review Nurse to join our Utilization... ...case reviews, check medical records and speak with care providers regarding... ...Responsibilities: Complete medical necessity reviews and level of care reviews for... ...~ Active, unrestricted RN licensure from the...Hourly payFull timeRemote workWork from homeHome officeWeekend work- Evry Health is seeking an RN Integrated Care Coordinator (UM) to provide comprehensive care coordination and drive quality outcomes across... ...care in a remote environment, with rotating weekend utilization review coverage. The candidate should have 1-2 years in utilization...Remote job
- ...are seeking a PRN RN to join our team!... ..., and directs home care services. Successful... ...Responsible for continuous review of all aspects of... ...: appropriate utilization of services; ensuring... ...in the medical record; maintenance... ...Admits to appropriate level of service/ care....Part timeReliefWork at officeLocal area
- ...the hemodialysis health care team providing safe and... ..., and efficiently utilizes supplies and equipment... ...in a timely manner. Reviews health care record for... ...control and moderate noise levels. May be exposed to infectious... ...Fresenius Medical Care maintains a drug-free...Immediate startFlexible hours
- ...Join our brand-new 56-bed Medical/Surgical Unit opening... ..., Patient-Centered Care to a diverse medical,... ...population with varying acuity levels. With dedicated and... ...Primary Purpose The RN is a licensed... ...patient's response. The RN utilizes knowledge of patient needs...Temporary workRelocation packageShift work
- ...A Registered Nurse (RN) with 2 years of experience... ...to coordinate patient care delivery, that focuses... ...'s response. The RN utilizes knowledge of patient needs... ...trauma informed medical forensic examination to... ...Participates in SANE Peer Review and quality assurance /...Full timeTemporary workTraineeshipWork at officeNight shift
$41 per hour
...Medical Review Nurse (RN) Remote position, however candidates must reside in the State of TX or State... ...RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan...Contract workRemote work$41 - $46 per hour
...Registered Nurse (RN) is a vital member... ...compassionate, evidence-based care in alignment with... .... By integrating medical and behavioral... ...readiness for the next level of care. Maintains... ...treatment team to review patient care, needs... ...assistance to Utilization Review in communicating...Full timeReliefShift workNight shiftRotating shiftDay shift- ...Wound Care Utilization Management RN Location: This role enables associates to work... ...plans with providers. Reviews Home based services for clinical... ...utilizing the members medical records and/or discussion with... ...looking for leaders at all levels of the organization who are...Full timeTemporary workLocal areaRemote workMonday to FridayShift work1 day per week
$1,950 - $2,050 per week
...Registered Nurse (RN) | Telemetry Location:... ...Tele) RN team, you will care for patients with a wide... ...heart rate, blood oxygen level and cardiac electrical... ...patients on the unit, utilizing specialized equipment.... ...As part of SUNY Upstate Medical University, this hospital...Extra incomeFull timeContract workTemporary workShift work- ...As a world-renowned medical and research center... ...the best possible care, resources, and benefits... ...-BNE Current Texas RN (or BNE Compact... ...and needs and utilizes them in conjunction... ...family. Ensures comfort level of post-discharge... ...participation in care. Reviews plan of care with...Full time
- ...RN Case Manager The RN Case Manager in this... ...the clinical plan of care to conform to evidence... ...integrates care coordination, utilization management, and... ...responsibilities include medical necessity screening, care... ...in weekly Complex Case Review, arranging for post-discharge...Work at office
- ...leader of the Patient Care Team and that member of... ...interdisciplinary plan of care. Reviews information on all... ...Monitors the type and level of team services provided (staffing, medications, HME, supplies, level... ...program review. Performs utilization review of continuous...Contract workLocal area
- Job Category: Managed Care Requisition Number: RNMAN... ...Registered Nurse (RN) to lead our Case Management... ...a strong focus on Utilization Review. The Manager of Case... ...departments and with medical staff to improve care... ...determine the appropriate level of care Understands...Full time
- ...Registered Nurse (RN)Helio Health is on a mission... ...taking vitals, passing medications, and identifying and acute... ...orders for patient care.Communicate with supervisor... ..., recommend, and review medical policies and procedures... ...candidate's education level and experience relevant...Hourly payFull timeLocal areaShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Review RN: Medical Necessity & Care Level. Be the first to apply!






