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- 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
$75k
HealthHelp - A WNS Company in Houston, Texas, is looking for a Registered Nurse (RN) to perform concurrent inpatient utilization reviews. The role requires a BSN and current nursing license, with preference for those with two years of inpatient clinical nursing experience...SuggestedRemote jobMonday to Friday$41.14 - $61.2 per hour
...Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency... ...responsible resource utilization. Every day, you will meticulously review medical records, authorize services, and prepare cases for...SuggestedCatholic Health Initiatives
Houston, TX4 hours ago- ...Remote Facility: Ascension Network Service Department: Utilization Management Schedule: Full Time l Day Life at Ascension... ..., case management, discharge planning, and utilization review. Review admissions and service requests for medical necessity...SuggestedFull timeLocal areaRemote work
Ascension
Austin, TX3 days ago $75k
HealthHelp - A WNS Company seeks a qualified RN for remote inpatient utilization review. The role involves clinical collaboration, ensuring compliance with medical necessity criteria. A minimum of two years in acute care and an active RN license are required. Benefits...SuggestedRemote job$75k
A healthcare services provider is looking for a Remote RN to perform inpatient utilization reviews. This role involves engaging with clinical teams to discuss medical necessity and managing multiple tasks under pressure. Candidates must hold a valid RN license and have...SuggestedRemote job- ...PRN Utilization Review RN - M-F Days Must be available to work daytime hours (between 8am-6:30pm) Monday - Friday WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork...SuggestedFull timeReliefWork at officeLocal areaMonday to FridayNight shift
University Of Texas Southwestern Medical Cent (The)
Dallas, TX17 days ago - ...looking for a dedicated professional to join their Utilization Management team. The role involves conducting reviews and evaluations for members needing... ...and federal regulations. This position requires an RN or LVN certification and at least three years of relevant...SuggestedWork at officeRemote work
Central Health
Austin, TX3 days ago $2,250 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in San Antonio, Texas. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 06/08/2026 ~ Duration...SuggestedTemporary workShift workAMN Healthcare Revenue Cycle
San Antonio, TX3 days ago$47.06k - $70.24k
...A healthcare solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness... ...with claims examiners. Candidates must have a current RN license and at least four years of clinical experience,...SuggestedRemote workCare Options For Kids
Fort Worth, TX4 hours ago$20.38 - $36.44 per hour
...Primary Responsibilities: Perform documentation reviews to assess medical necessity and benefit correlation for requested... ...license or current multistate/compact LVN license ~2+ years of utilization review experience at a health plan, ACO, IPA, or provider group...SuggestedHourly payMinimum wageFull timeWork experience placementLocal areaOptum
Pearland, TX4 hours ago- Harris Health System, Inc. is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, TX. This position involves evaluating medical service... ...include a Bachelor’s in Nursing and being a licensed RN in Texas, alongside significant experience in healthcare settings...SuggestedRemote jobFlexible hours
- A regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of medical services based on necessity and promoting quality care outcomes. The candidate must have a Bachelor's in Nursing and...SuggestedRemote jobFlexible hours
- ...vacancies, visit or Job Title: Nurse Case Manager - Utilization Review Requisition Number: 44170 Employment Type: Full... ...Required Licensure/Certification/Specialized Training: RN licensure through the Texas State Board of Nurse Examiners....SuggestedHourly payFull timeShift workDay shift
JPS Health Network
Fort Worth, TX3 days ago - 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 to ensure appropriate...SuggestedFull timeLocal areaShift work
- FALL CREEK FARM & NURSERY is hiring a Utilization Review Nurse (Nurse II) in San Antonio, Texas. This full-time position, part of the Texas Health and Human Services Commission, requires a Registered Nurse license in Texas and involves making service authorization decisions...Full timeRemote 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...Full time
- Cook Children's in Fort Worth, TX seeks an RN Reviewer for full-time position. The role involves coordination and efficient utilization of health care resources for Cook Children's Health Plan members, assessing clinical information and determining medical necessity for...Full time
$72k - $76k
Injury Management Organization, Inc. in Plano, TX is seeking a Full-Time Registered Nurse specializing in Utilization Review. This hybrid position is ideal for RNs experienced in Workers' Compensation, where you'll apply your critical thinking skills while ensuring optimal...Full time- ...Utilization Review Nurse The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care services. Through... ...most in need. The UR nurse will also assist Registered Nurse (RN) Case Managers and Social Workers with helping patients make...Full timeWork at officeMonday to FridayShift work
Midland Memorial Hospital
Midland, TX3 days ago $75k
A healthcare service provider seeks a remote RN to conduct inpatient utilization reviews based on InterQual criteria. The role involves direct collaboration with physicians and maintaining compliance with documentation policies. Applicants should have at least two years...Remote job- Houston Methodist is seeking a Manager for Centralized Utilization Review in Katy, Texas. In this role, you will lead operations to ensure high... ...degree in Nursing, five years of relevant experience, and Texas RN licensure. A Master's degree and management experience are...
- ...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...Full timeRemote work
Innovative Systems Group
Richardson, TX4 hours ago - ...Dunn Behavioral Sciences Center. Candidates must have a BSN and RN State Licensure, alongside three years of nursing experience, preferably... ...include securing timely payments, conducting case reviews, and implementing policies. Join a dedicated team serving the area...Full time
$38 - $40 per hour
...Richardson area - Dallas/Collin Counties 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...Hourly payContract workWork at officeRemote workMadea Home Care Services
Plano, TX2 days ago- ...Utilization Management Review Nurse Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community...Work experience placementWork at officeRemote workFlexible hoursWeekend work
Harris Health System
Bellaire, TX2 days ago - ..., Days, Not a Remote position. Hours: 8:30-5:30, Monday - Friday At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity...Permanent employmentFull timeWork experience placementWork at officeLocal areaMonday to Friday
Houston Methodist
Shenandoah, TX4 days ago - ...Utilization Review Nurse San Jacinto Plaza - Sunflower Building - El Paso, TX 79901; El Paso Childrens Hospital - El Paso, TX 79905 Overview... .... License/Registration/Certification: ~ Current RN License to practice in the State of Texas. Education...Full timeWork experience placementWork at officeShift work
El Paso Children's Hospital
El Paso, TX4 days ago - ...A leading healthcare solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal candidate... ...have over 5 years of clinical experience and must hold an active RN license. Responsibilities include reviewing medical records, performing...Full timeRemote work
Gainwell Technologies
El Paso, TX4 hours ago - ...providing training in healthcare services. Interns will conduct clinical reviews, communicate with healthcare providers, and ensure compliance with regulations. Candidates must hold an active RN license and have at least two years of behavioral health experience. The position...Remote jobInternshipWeekday work
