Utilization Review Nurse - Evidence-Based Care Coordinator

Tristar-d43fac80

Tristar-d43fac80 is seeking an experienced RN for utilization review and case management in Irving, Texas. Responsibilities include prospective, concurrent, expedited, and retrospective reviews to determine medical necessity and appropriate care using evidence-based guidelines.

You will coordinate discharge planning, refer high-need claimants to Case Management, and work with Telephonic Case Management/Pharmacy TCM to align next steps with URAC standards.

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Vacancy posted 3 days ago

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