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Utilization Review Rn Jobs in Mansfield, TX (NOW HIRING)

ScionHealth

Case Manager

Ennis, TX · On-site

$18.50 - $23.75/hr

Perform medical necessity reviews and assess the appropriateness of clinical resource utilization ... Postsecondary (Certificate, Diploma, or Program Graduate) - RN or LPN/LVN Diploma, Associate's, or ...

Elevance Health

Med Mgmt Nurse

Grand Prairie, TX · On-site

... utilization review, or managed care experience; or any combination of education and experience, which would provide an equivalent background. * Current active, valid and unrestricted RN license and ...

Elevance Health

Med Mgmt Nurse

Grand Prairie, TX · On-site

... utilization review, or managed care experience; or any combination of education and experience, which would provide an equivalent background. * Current active, valid and unrestricted RN license and ...

Palm Medical Centers

RN Clinical Coordinator

Dallas, TX · On-site

$75K/yr

The RN Clinical Coordinator performs a variety of tasks and coordinates the plans of care for ... Utilization Management Department. Responsibilities include: * Admit new clients by reviewing ...

Palm Medical Centers

RN Clinical Coordinator

Dallas, TX · On-site

$70K/yr

The RN Clinical Coordinator performs a variety of tasks and coordinates the plans of care for ... Utilization Management Department. Responsibilities include: * Admit new clients by reviewing ...

U9887

RN Case Manager - Weekends

Dallas, TX

RN Case Manager Full-Time Weekends Friday, Saturday, Sunday 6:45am - 7:15pm WHY UT SOUTHWESTERN ... Collaborates with Social Work, Utilization Review, Clinical Documentation Specialists, and others ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Mansfield, TX

Utilization Review Rn information

See Mansfield, TX salary details

$19

$37

$61

How much do utilization review rn jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for utilization review rn in Mansfield, TX is $37.89, according to ZipRecruiter salary data. Most workers in this role earn between $29.95 and $43.51 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 popular job titles related to Utilization Review Rn jobs in Mansfield, TX?

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

What job categories do people searching Utilization Review Rn jobs in Mansfield, TX look for?

The top searched job categories for Utilization Review Rn jobs in Mansfield, TX are:

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

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

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Mansfield, TX as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, 4% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $78,819 per year, or $37.9 per hour.

Case Manager ( RN / RT / SW / LPN )

Select Medical

Desoto, TX • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Job description

Select Specialty Hospital

Critical Illness Recovery Hospital (LTACH)

Case Manager

Full Time: Monday-Friday 8-5pm

Requires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR  Medical Social Work  (license per state guidelines).

And

Previous discharge planning experience preferred.

Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives – and our team plays a central role in providing compassionate, excellent care every step of the way.


We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.

The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.

  • Develops and implements a patient specific, safe and timely discharge plan.
  • Performs verification of utilization criteria reviews.
  • Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
  • Demonstrates compliance with facility-wide Utilization Management policies and procedures.
  • Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
  • Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
  • Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.

We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.

Minimum requirements:

  • Current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist (RN preferred) OR current license / certified Social Work license per state guidelines
  • Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients. (example: ICU, step-down, med surg, vents)

Preferred qualifications that will make you successful:

  • Specific experience in Care Management and Discharge Planning is preferred.
  • Working knowledge of the insurance industry and government reimbursement.

General Benefits Full-time

  • Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
  • Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
  • Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP)  and dental plan offerings for full-time team members
  • Invest in Your Future:Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
  • Your Impact Matters:Join a team of over 44,000 committed to providing exceptional patient care

Equal opportunity employer, including disabled veterans

Apply