RN Utilization Review Specialist — Case Management Lead
Methodist Hospital for Surgery
Methodist Hospital for Surgery in Addison, TX is seeking an RN Utilization Review Coordinator in the Case Management department. The role performs prospective, concurrent, and post-discharge reviews to ensure medical necessity and regulatory compliance. You will collaborate with physicians, nurses, and payers, support discharge planning, and contribute to quarterly utilization reports and quality initiatives. A Texas RN license and 5+ years of relevant experience are expected. #J-18808-Ljbffr Methodist Hospital for Surgery
- Surgery Partners Brand seeks an RN Utilization Review Coordinator for Methodist Hospital for Surgery in Addison, TX. This full-time, hybrid... ...candidate will collaborate with physicians and the Case Management team, manage denials, and contribute to discharge planning...SuggestedFull time
- Job Category : Managed Care Requisition Number : RNMAN035973 Posted : October 15, 2026 Full-Time On-site Locations... ...Addison, TX 75001, USA Description Hiring Now for RN Utilization Review Coordinator Department: Case Management Shift: Full-time Hybrid Job Summary:...SuggestedFull timeLocal areaShift work
- ...Healthcare Reimbursement With Your RN Expertise ERISA Recovery is seeking... ...Nurse (RN) with a strong background in utilization management, clinical review, and denial appeals to join our... ...necessity reviews (inpatient & outpatient cases) Develop and submit high-quality...SuggestedRelocation
- McKim & Creed, Inc. seeks a Utility Locator III to lead a field crew in utility location and SUE activities. You will gather field data, designate features, and deliver accurate data to the office with strong records of work and expenses. The role requires expertise with...SuggestedWork at officeNight shift
- Job Category : Provider Management Requisition Number : UTILI004408 Posted :... ...Description Position Summary The Utilization Management & Case Review Specialist is responsible for conducting utilization... ...department's budget. Leadership - Leads by serving others first, showing...SuggestedFull timeFor contractorsWork at officeLocal areaNight shift
- Select Specialty Hospital in Plano, TX is seeking a Case Manager to oversee discharge planning, utilization reviews and social work services for chronically ill patients in a LTACH setting. This full-time role requires collaboration with physicians, nurses, respiratory...Full time
- Select Specialty Hospital is seeking a Case Manager at its Critical Illness Recovery Hospital... ...(LTACH) to oversee discharge planning, utilization reviews and treatment plan management. This... ...active licensure in a clinical discipline (RN/LPN/LVN or RT) or a Social Work license...Full time
- ...Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive... ...weekend hours are required to address utilization review cases. Roles and Responsibilities... ...reviews with emphasis on utilization management, discharge planning, care coordination...Live inRemote workFlexible hoursWeekday work
- ...AMLI Residential is seeking an Applicant Review Specialist to join our Resident Services Group at... ...teams and the Credit & Collections Manager, you will assess income, credit, rental... ...environment for all employees. The Company may utilize artificial intelligence, as permitted...Work at officeLocal area
- 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 Friday, 8am-5pm is required. You will collaborate with the Central Scheduling...ReliefMonday to FridayFlexible hours
- UT Southwestern Medical Center in Dallas seeks an experienced Utilization Review RN for weekend PRN shifts. You will conduct medical necessity reviews for acute care services and collaborate with physicians to determine appropriate levels of care. Strong knowledge of evidence...ReliefShift workWeekend work
- ...Medical Center seeks a Registered Nurse for medical necessity Utilization Review in our Dallas facility. The role involves reviewing admissions... ...physicians and care teams. The ideal candidate has an active Texas RN license, 5 years of experience including clinical and...
- ...together with us by becoming a Lead Generation Specialist At CompuGroup Medical we... ...produce access and utilize information and thus enabling... ...Research potential prospects review buyer profiles and assess their... ...: Log call outcomes and manage leads within CRM/SAP...Full timeFlexible hours
- ...other job-related tasks as directed by management. To perform this job successfully, an... ...conducted in the store. Assists other Event Specialists with event kits, materials and tools as... ...at the time of posting. Acosta Group utilizes E-Verify for validating the ability to...Hourly payLocal areaImmediate start
- ...practice (.)You Are:A senior Oracle Utilities Integration Lead who brings both the architectural vision... ...data mapping artifacts.Establish and manage integration testing strategy and... ...analysts, setting delivery standards, reviewing technical designs, and ensuring adherence...Full timeWork experience placementLive inWork at officeLocal areaRemote work
- We are seeking a Lead Information Security Specialist to safeguard critical enterprise Unix/Linux/Mainframe... ...specialized expertise in privileged access management, sudo administration, and RACF... ..., and Perl to streamline access reviews, policy enforcement, and compliance...Full timeWork at office
- ...world-class training facility, and leading market tools, we help our people... ...KPMG is currently seeking a Lead Specialist, Oracle EBS RTR Lead to join our Managed Services practice.... ...implementationlifecycle support and project reviews; identify, document and manage clientbusiness...H1bLocal areaVisa sponsorshipWork visa
- We are seeking a Lead Information Security Operations Specialist with a focus on privileged access management. This role will be responsible for being a subject matter expert in... ...To learn more about your benefits, please review our Benefits Summary.Equal Opportunity We...Full timeWork at office
$114.1k - $268.18k
...world-class training facility, and leading market tools, we help our people... ....KPMG is currently seeking a Lead Specialist, Cloud Security to join our Managed Services practice.Responsibilities... ...Azure environments, governing the review, prioritization, remediation, and...H1bLocal area- UT Southwestern Medical Center is seeking an experienced RN for Home Infusion Services in the Dallas area. The Home Infusion Services RN provides specialized nursing care and case management for infusion therapy in patient homes, under Nursing Manager supervision. The role...
- Job Description ECMO Specialist RN Nights 5K Bonus (898843) WHY UT SOUTHWESTERN... ...the ECMO device and manages ECMO-related care for adults... ...needs and expectations and utilizes these in conjunction with the... ...participation in care. Reviews personalized patient plan of...Hourly payFull timeRelocation packageShift workNight shift
- ...efficient, cost effective care management process by determining... ...knowledge and skill set related to utilization review, care coordination,... ...Must have current, valid RN license or temporary RN license... ...Coordination team to develop a case management plan of care. Gathers...Full timeTemporary workShift workAfternoon shift
- ...Plano, TX, seeks an experienced Registered Nurse (RN) to move beyond bedside care into utilization management and clinical review. You will analyze denied claims, perform... ...necessity reviews for inpatient and outpatient cases, and develop high-quality clinical appeals with...
- FOOD & NUTRITION REVIEW TEAM LEAD (Community Operations) Salary Information: B25, $6,300 - $6... ...applicable program, financial and procurement management standards, including (but not limited... ...and accounting records/systems, utilizing standard compliance audit/review...Remote 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
$90k - $100k
...Services, LLC Field Safety Specialist We are seeking a... ...specifically within the Electric Utility Industry on Substation... ...ideal candidate will lead systems-based... ...identify root causes, management deficiencies, and... ...Support the development and review of safety plans, wire-...Contract workFor contractorsWork at officeLocal areaRemote workFlexible hours- AECOM is seeking a talented Proposal Specialist III to join the West Region BD and operations... ...has offices. Responsibilities include leading medium to large proposals, crafting outlines... ..., schedule, and quality through color reviews and debriefs. #J-18808-Ljbffr AECORemote job
- ...the CDI, Coding, and Quality teams. You will perform second-level reviews of inpatient records to improve documentation integrity and identify opportunities for improvement. The role includes managing post-discharge workflows, evaluating potential PSIs, and responding...
- ...Texas Southwestern Medical Center in Dallas is seeking a PRN Utilization Review Nurse to conduct medical necessity reviews for acute care. You... ...graduates of accredited nursing programs with an active Texas RN license and at least 5 years of clinical experience including...Relief
- ## Lead Specialist, Product MarketingApplylocations: US, TX, Dallas, Tollwaytime type: Full timeposted... ...results-oriented Strategic Marketing Manager to join our GMSL team. In this role,... ...have to go through an export licensing review process.**Analog Devices is an equal...Permanent employmentWork at officeWorldwideDay shift
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Utilization Review Specialist — Case Management Lead. Be the first to apply!
- public health registered nurse Addison, TX
- temporary rn Addison, TX
- part time rn Addison, TX
- travel registered nurse l&d Addison, TX
- nicu registered nurse Addison, TX
- rn urgent care Addison, TX
- rn skilled nursing facility Addison, TX
- travel clinic rn Addison, TX
- part time clinic rn Addison, TX
- labor delivery registered nurse Addison, TX




