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Utilization Review Case Management Rn Jobs in Texas

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Utilization Review Case Management Rn information

What cities in Texas are hiring for Utilization Review Case Management Rn jobs?

Cities in Texas with the most Utilization Review Case Management Rn job openings:

Utilization Management Registered Nurse

Austin, TX • On-site

Ascension Seton - Austin
See more jobs at Ascension Seton - Austinexternal

$1.7K/wk

Other

Posted 9 days ago

Job description

Details
Client Name
Ascension Seton - Austin
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
Case Manager
Job ID
35561619
Job Title
Utilization Management Registered Nurse
Weekly Pay
$1751.31
Shift Details
Shift
Day - 8x5 - 09AM
Scheduled Hours
40
Job Order Details
Start Date
10/06/2026
End Date
01/04/2027
Duration
13 Week(s)
Job Description
Job Title: RN Utilization Review
Profession: Nursing
Specialty: Utilization Review
Duration: 13 weeks
Shift: Day
Hours per Shift: 8.5
Experience: Minimum 2 years in acute care utilization management or equivalent
License: Licensed RN (multistate or Texas RN)
Certifications: BLS
Must-Have:
- Proficiency with InterQual/MCG and CMS regulations.
- Experience with payor portals, managed Medicare and Medicaid insurers.
- Proficient and adaptable in using multiple technologies simultaneously.
- Remote work experience preferred.
Description:
Provides health care services regarding admissions, case management, discharge planning, and utilization review.
Reviews admissions and service requests for prospective, concurrent, and retrospective medical necessity and compliance with reimbursement policy criteria.
Provides case management and consultation for complex cases.
Assists departmental staff with coding, medical records/documentation, precertification, reimbursement, and claim denials/appeals.
Assesses and coordinates discharge planning needs with healthcare team members.
May prepare statistical analysis and utilization review reports as necessary.
Oversees and coordinates compliance with federally mandated and third-party payer utilization management rules and regulations.
Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision.
Must be able to work in a stressful environment.
Centralized acute admission utilization review across various care settings.
Client Details
Address
1345 Philomena St
City
Austin
State
TX
Zip Code
78723
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