RN - Utilization Review
Innovative Systems Group
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 and knowledge of accreditation standards. Candidates must reside in IL or TX and possess strong communication skills to interact with providers and members. #J-18808-Ljbffr
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the RN - Utilization Review in Richardson, TX vacancy
- 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...Suggested
- 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
- 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...SuggestedWork at office
- Job Details Description Hiring Now for RN Utilization Review Coordinator Department: Case Management Shift: Full-time Hybrid Job Summary The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post‑discharge utilization reviews...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
- 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...
$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...Contract workWork at officeRemote workHireOps Staffing LLC
Dallas, TX4 days ago- ...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
Innovative Systems Group
Richardson, TX1 day ago $59k - $75.05k
...Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service,... ...'ll Bring to Zelis: Current/active RN License. Typically has a BA or 3-5 years... ...long period of computer work while utilizing multiple computer screens at one time....Full timeWork at officeLocal areaVisa sponsorshipFlexible hoursZelis
Plano, TX2 days ago$35 - $45.94 per hour
...Description Job Description Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role:... ...duties as assigned Requirements: ~ Active, unrestricted RN licensure from the United States in [state], OR, active compact...Hourly payFull timeRemote workWork from homeHome officeWeekend workOscar Health
Dallas, TX7 days ago- 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...
$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...Permanent employmentRemote work2 days per weekTEKsystems
Addison, TX1 day ago- ...to do so • Work experience: Six months RN experience Your Job Responsibilities:... ...promote a cooperative work environment by utilizing communication skills, interpersonal... ...Work in Healthcare by Becker’s Hospital Review, 2023 ~ Top 10 Military Friendly® Employer...Work experience placementNight shiftRotating shift
- ...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-...Full timePart timeWeekend work
Bradford Health Services
Dallas, TX4 days ago - ...Job Description Job Description The Reny Company's bill reviewer is a professional who combines experience in health insurance and... ...accuracy and appropriateness. This support is achieved by utilizing intelligent software and by understanding and applying knowledge...Hourly payWork experience placement
The Reny Company
Plano, TX3 days ago - A healthcare organization is seeking Board-Certified physicians in Oncology for a flexible, remote utilization review role. This position requires a Medical Degree (MD or DO) with a current license in Florida, Minnesota, or Oregon, and an active Board Certification in...Remote jobFlexible hours
- ...build a winning team. • Registered Nurse (RN) renders highly professional and... ...procedures, and nursing care standards and utilizes these when providing nursing care. • Work... ...Work in Healthcare by Becker’s Hospital Review , 2023 ~ Top 10 Military Friendly® Employer...Full timeWork experience placementNight shiftRotating shift
Methodist Health System
Richardson, TX15 days ago - Methodist Surgery Center in Addison, Texas, is seeking an experienced Utilization Review Specialist to join its team. The role requires the ability to work independently with minimal training and to manage complex cases in a fast-paced environment. This is a hybrid position...Remote job3 days per week
- ...This position is 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...Remote jobContract work
- ...to do so • Work experience: Six months RN experience Your Job Responsibilities:... ...promote a cooperative work environment by utilizing communication skills, interpersonal... ...Work in Healthcare by Becker’s Hospital Review , 2023 ~ Top 10 Military Friendly® Employer...Work experience placementReliefShift workNight shift
- ...compensation model. The physicians will conduct health claim reviews and ensure compliance with Concentra's policies. Candidates must... .... Additional responsibilities include recommendations for utilization reviews and timely case management. #J-18808-Ljbffr ConcentraRemote job
- ...population for which he or she is employed. The RN is accountable for their practice and... ...RN is expected to practice autonomously utilizing evidence based practices. The practice of... ...Inpatient Rehab opening. We promptly review all applications. Highly qualified candidates...Temporary workFlexible hours
Mission Hospital
Plano, TX2 days ago $180k - $230k
...via our website, please only use Additionally, our recruiters utilize email addresses with the @lifestance.com domain. Other websites... ...not be sent to this email addressas they will not be reviewed or responded to. To apply for a position, please use our officialcareers...Work at officeRelocation packageLifeStance Health
Plano, TX4 days ago- ...population for which he or she is employed. The RN is accountable for their practice and... ...RN is expected to practice autonomously utilizing evidence based practices. The practice of... ...Nurse NICU opening. We promptly review all applications. Highly qualified candidates...Full timeTemporary workPart timeFlexible hours
Medical City Healthcare
Plano, TX4 days ago - ...all emergency operational procedures. Communicate and regularly review Emergency Preparedness procedures with all home patients, including... ...essential duty satisfactorily. Requirements include: Current RN license in applicable state. License must be maintained as current...Full timePart timeLocal areaMonday to FridayFlexible hoursNight shiftWeekend work
US Renal Care
Richardson, TX1 day ago - ...responsibility” assigned to the Inpatient Services RN, for a limited period of time, and for specific... ...ensure efficient patient scheduling and staff utilization in accordance with the TAP scheduling tool. Maintain and review the daily TAP tool for all hospitals/facilities...Local areaWorldwide
CH01 CHE Fresenius Medical Care (Schweiz) AG
Dallas, TX1 day ago - ...Texas or eligibility to do so • Work experience: at least 6 months RN experience Your Job Responsibilities: • Communicate clearly and... ...~150 Top Places to Work in Healthcare by Becker’s Hospital Review , 2023 ~ Top 10 Military Friendly® Employer, Gold Designation,...Work experience placementShift workWeekend work
- ...Infusion Registered Nurse (RN) – Oncology Location:6957 W Plano Pkwy Suite 2000 Plano... ...and maintain central venous access devices. Review laboratory results and assist physicians with... ...of patients undergoing cancer treatment. Utilize advanced infusion nursing skills in a...
A-Line Staffing Solutions
Plano, TX2 days ago - ...Certificates/Eligibility: Current Texas RN license, BLS and ACLS required. Two (2) years... ...manage time appropriately. Ability to utilize resources in a timely, organized and cost... ...preoperative patient assessment, reviews surgeon preference card, assesses equipment...
BELTLINE SURGERY CENTER, LLC
Richardson, TX4 days ago - ...Hiring Now for RN PreOp/PACU PRN at Methodist Surgery Center, Richardson TX To provide... ...To act as a resource person to manage and utilize personnel in an effective and appropriate... ...laws. For further information, please review the Know Your Rights notice from the Department...Relief
Surgery Partners
Plano, TX1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN - Utilization Review. Be the first to apply!
Related searches
- unique rn Richardson, TX
- travel registered nurse rn Richardson, TX
- rn outpatient surgery Richardson, TX
- rn no experience Richardson, TX
- behavioral rn Richardson, TX
- pediatric icu rn Richardson, TX
- private rn Richardson, TX
- charge registered nurse Richardson, TX
- progressive care unit registered nurse Richardson, TX
- clinic registered nurse rn Richardson, TX