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Contract Rn Case Review Jobs in Texas (NOW HIRING)

Mission Hospital

RN - Case Manager

Dallas, TX

$1K/wk

RN,TRAVEL- RN - Case Management (918) / MC Dallas / 8A-4:30P, City: Dallas, State: Texas, Estimated ... Contract (Days) : 91, Estimated Gross Pay: 0.00 Convergence Medical Staffing is known for ...

IntelyCare

RN Case Manager

Fort Worth, TX · On-site

Utilization Review experience highly preferred * What You Will Do In This Role: * Performs a ... RN Case Manager opening. We review all applications. Qualified candidates will be contacted by a ...

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Contract Rn Case Review information

How does a Contract RN Case Review professional typically collaborate with other healthcare team members?

As a Contract RN Case Review professional, you'll frequently coordinate with physicians, social workers, and other nursing staff to ensure comprehensive patient care. Collaboration often involves reviewing patient charts, discussing care plans, and providing recommendations for discharge planning or ongoing management. Effective communication is key, as you'll need to relay findings and updates to both internal teams and external case managers. This role often requires balancing independent, detailed review work with regular interdisciplinary meetings to drive optimal outcomes for patients.

What are the key skills and qualifications needed to thrive as a Contract RN Case Review, and why are they important?

To thrive as a Contract RN Case Review, you need a valid RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical coding systems (such as ICD-10, CPT), case management software, and knowledge of regulatory guidelines like Medicare and Medicaid are typically required. Excellent analytical thinking, attention to detail, and effective communication skills are crucial soft skills for this role. These competencies ensure accurate case assessments, compliance with healthcare regulations, and effective collaboration with providers and payers.

What is the difference between Contract Rn Case Review vs Contract Rn Case Management?

AspectContract Rn Case ReviewContract Rn Case Management
CertificationsRN license, case review certificationsRN license, case management certifications (e.g., CCM)
Work EnvironmentReviewing medical records, assessing casesCoordinating patient care, managing cases
Employer & IndustryInsurance companies, healthcare agenciesHealthcare providers, insurance companies
Search & Comparison IntentUnderstanding case review roles, job differencesExploring case management careers, job duties

Contract Rn Case Review focuses on evaluating medical records and determining coverage or compliance, while Contract Rn Case Management involves coordinating patient care and managing cases throughout treatment. Both roles require RN licensure, but they differ in daily tasks and responsibilities within the healthcare and insurance industries.

What is a Contract RN Case Review nurse?

A Contract RN Case Review nurse is a registered nurse who is hired on a contractual basis to evaluate patient cases, often for insurance companies, hospitals, or healthcare organizations. Their main duties include reviewing medical records, ensuring compliance with clinical guidelines, and providing recommendations for patient care or coverage decisions. These nurses typically work remotely or in office settings and may be responsible for communicating findings to healthcare providers or insurance adjusters. This role requires strong clinical knowledge, attention to detail, and excellent communication skills.
What are the most commonly searched types of Rn Case Review jobs in Texas? The most popular types of Rn Case Review jobs in Texas are:
What cities in Texas are hiring for Contract Rn Case Review jobs? Cities in Texas with the most Contract Rn Case Review job openings:
Contract Rn Case Review jobs near you
Case Manager RN

Case Manager RN

Dallas Regional Medical Center

Mesquite, TX • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Dallas Regional Medical Center rating

8.3

Company rating: 8.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

77th of 995 rated hospitals

Job description

Overview
We are seeking an RN Case Manager, also referred to as a Registered Nurse Case Manager or RN Clinical Case Manager. An RN Case Manager will oversee and coordinate patient care from admission through discharge to ensure quality, cost-effective outcomes. They assess patients' needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare systems.
Shift's Available: Days
Employment Type: Full Time
Hours: 8 hour - 8a-4pm
Location: Dallas Regional Medical Center - Mesquite, TX
Here are some of the benefits of working at Prime Healthcare:
  • Health, dental, and vision insurance options
  • Paid vacation, sick time and holidays
  • Bereavement leave, FMLA and other leave options
  • Employer 401K options
  • Tuition reimbursement options
  • Life, disability, and other insurance options
  • Many other amazing benefits

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/
Responsibilities
Essential Duties and Responsibilities (includes, but not limited to):
  • Patient Assessment: evaluate patients' medical, psychosocial, and discharge needs upon admission and throughout their stay
  • Care Coordination: develop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions
  • Discharge Planning: coordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities
  • Utilization Review: monitor the use of hospital resources and services to ensure appropriate care and avoid unnecessary treatments or extended stays
  • Patient and Family Education: help patients and families understand care plans, post-discharge instructions, and available resources
  • Advocacy: advocate for patient needs and preferences, ensuring care is aligned with their goals and values

Qualifications
Before we go any further, we do have some deal-breakers. You must have:
  • Current and valid state RN License
  • BLS certification within 30 days and maintain current

Additional Required Knowledge, Skills & Abilities:
  • Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred.

Additional Qualifications That Are a Plus:
  • Knowledge of Milliman Criteria and InterQual Criteria preferred.
  • Experience and knowledge in basic to intermediate computer skills.
  • Behavioral Violence Prevention Training within 3 months of hires and maintain current.

Employment Status
Full Time
Shift
Days
Equal Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

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