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Utilization Review Rn Jobs in Corpus Christi, TX

... transcribes and reviews provider's orders ensuring all required elements are present and ... RN. * Ensures thorough, accurate documentation is completed for all clients on each shift and ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

Showing results 21-40

Utilization Review Rn information

See Corpus Christi, TX salary details

$17

$34

$56

How much do utilization review rn jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for utilization review rn in Corpus Christi, TX is $34.92, according to ZipRecruiter salary data. Most workers in this role earn between $27.60 and $40.10 per hour, depending on experience, location, and employer.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What are the key skills and qualifications needed to thrive as a utilization review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Corpus Christi, TX?

The most popular types of Utilization Review Rn jobs in Corpus Christi, TX are:

What are popular job titles related to Utilization Review Rn jobs in Corpus Christi, TX?

For Utilization Review Rn jobs in Corpus Christi, TX, the most frequently searched job titles are:

What cities near Corpus Christi, TX are hiring for Utilization Review Rn jobs?

Cities near Corpus Christi, TX with the most Utilization Review Rn job openings:

Infographic showing various Utilization Review Rn job openings in Corpus Christi, TX as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $84,952 per year, or $40.8 per hour.

MDS Coordinator (Registered Nurse/RN)

Wooldridge Place Nursing Center

Corpus Christi, TX โ€ข On-site

$28.50 - $34.50/hr

Full-time

This job post hasย expired 2 days ago.ย Applications are no longer accepted.


Job description

Position Summary

The RN MDS Coordinator coordinates and assists with completion and submission of accurate and timely interdisciplinary MDS Assessments, CAAs, and Care Plans according to CMS RAI Manual Regulations and in accordance with all applicable laws, regulations, and Life Care standards.

Education, Experience, and Licensure Requirements
  • Associate's or bachelor's degree in nursing from an accredited college or university
  • Currently licensed/registered in applicable State. Must maintain an active Registered Nurse (RN) license in good standing throughout employment.
  • Two (2) years' nursing experience. Geriatric nursing experience preferred.
  • CPR certification upon hire or obtain during orientation. CPR certification must remain current during employment.
Specific Job Requirements
  • Advanced knowledge in field of practice
  • Make independent decisions when circumstances warrant such action
  • Knowledgeable of practices and procedures as well as the laws, regulations, and guidelines governing functions in the post acute care facility
  • Implement and interpret the programs, goals, objectives, policies, and procedures of the department
  • Perform proficiently in all competency areas including but not limited to: patient rights, and safety and sanitation
  • Maintains professional working relationships with all associates, vendors, etc.
  • Maintains confidentiality of all proprietary and/or confidential information
  • Understand and follow company policies including harassment and compliance procedures
  • Displays integrity and professionalism by adhering to Life Care'sย Code of Conductย and completes mandatoryย Code of Conductย and other appropriate compliance training
Essential Functions
  • Coordinate and assist with completion and submission of interdisciplinary, accurate, and timely MDS Assessments, CCAs, and Care Plans according to CMS RAI Manual Regulations
  • Report any changes in a patient's condition identified by the MDS Assessment to the DON
  • Provide education to direct care associates regarding updates or changes to the CMS RAI Manual or Skilled Nursing Facility Regulations that impact documentation
  • Assist with review of the Interdisciplinary Comprehensive Care Plan
  • Review Final Validation Reports and attest that all assessments have been completed and accepted into the CMS QIES system prior to billing and notify the Business Office when assessments are not ready to bill
  • Review CMS Reports to identify assessments completed or submitted late and develop systems and processes to prevent reoccurrence
  • Attend and participate in the Daily PPS Meeting, Monthly Triple Check, and other meetings upon request
  • Perform functions of a staff nurse as required
  • Exhibit excellent customer service and a positive attitude towards patients
  • Assist in the evacuation of patients
  • Demonstrate dependable, regular attendance
  • Concentrate and use reasoning skills and good judgment
  • Communicate and function productively on an interdisciplinary team
  • Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours
  • Read, write, speak, and understand the English language

An Equal Opportunity Employer