Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
RN Case Manager
Mission, TX · On-site
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
RN Case Manager
Mission, TX · On-site
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
Case Manager RN
Mission, TX · On-site
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
Case Manager RN
Mission, TX · On-site
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
Case Manager RN
Mission, TX · On-site
We are seeking an RN Case Manager , also referred to as a Registered Nurse Case Manager or RN ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
Case Manager RN
Mission, TX · On-site
We are seeking an RN Case Manager , also referred to as a Registered Nurse Case Manager or RN ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: monitor the use of hospital resources and services to ensure appropriate care ...
RNCase Manager
Mission, TX · On-site
... 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 ...
RNCase Manager
Mission, TX · On-site
... 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 ...
... 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 ...
... 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 ...
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
The RN Case Manager provides clinically based case management, discharge planning, and care ... guidelines and regulations pertaining to utilization review and discharge planning.
Must be registered as a Registered Nurse by the State of Texas or a state that recognizes ... utilization review and control measures. Fluent in English and Spanish (speak, read, and write)
Must be registered as a Registered Nurse by the State of Texas or a state that recognizes ... utilization review and control measures. Fluent in English and Spanish (speak, read, and write)
Registered Nurse IV
Edinburg, TX · On-site
$81K/yr
Must be registered as a Registered Nurse by the State of Texas or a state that recognizes ... utilization review and control measures. Fluent in English and Spanish (speak, read, and write)
Registered Nurse IV
Edinburg, TX · On-site
$81K/yr
Must be registered as a Registered Nurse by the State of Texas or a state that recognizes ... utilization review and control measures. Fluent in English and Spanish (speak, read, and write)
Do you have the PRN career opportunities as a Registered Nurse RN Mother Baby PRN you want with ... reviews plan of care for six to eight postpartum mothers or four dyads based upon initial ...
Do you have the PRN career opportunities as a Registered Nurse RN Mother Baby PRN you want with ... reviews plan of care for six to eight postpartum mothers or four dyads based upon initial ...
Do you have the PRN career opportunities as a Registered Nurse RN Mother Baby PRN you want with ... reviews plan of care for six to eight postpartum mothers or four dyads based upon initial ...
Do you have the PRN career opportunities as a Registered Nurse RN Mother Baby PRN you want with ... reviews plan of care for six to eight postpartum mothers or four dyads based upon initial ...
Do you have the PRN career opportunities as a Registered Nurse RN Mother Baby PRN you want with ... reviews plan of care for six to eight postpartum mothers or four dyads based upon initial ...
Do you have the PRN career opportunities as a Registered Nurse RN Mother Baby PRN you want with ... reviews plan of care for six to eight postpartum mothers or four dyads based upon initial ...
Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
Case Manager RN FT Edinburg
Edinburg, TX · On-site
Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
Case Manager RN FT Edinburg
Edinburg, TX · On-site
Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...
Utilization Review Rn information
See McAllen, TX salary details
$20.32 - $24.44
2% of jobs
$24.44 - $28.55
9% of jobs
$31.36 is the 25th percentile. Wages below this are outliers.
$28.55 - $32.66
21% of jobs
The median wage is $35.98 / hr.
$32.66 - $36.77
23% of jobs
$36.77 - $40.88
13% of jobs
$44.08 is the 75th percentile. Wages above this are outliers.
$40.88 - $44.99
10% of jobs
$44.99 - $49.10
8% of jobs
$49.10 - $53.21
5% of jobs
$53.21 - $57.32
5% of jobs
$57.32 - $61.43
2% of jobs
$61.43 - $65.54
2% of jobs
$20
$40
$65
How much do utilization review rn jobs pay per hour?
As of Jul 16, 2026, the average hourly pay for utilization review rn in McAllen, TX is $40.17, according to ZipRecruiter salary data. Most workers in this role earn between $31.73 and $46.15 per hour, depending on experience, location, and employer.
How to get into utilization review as a nurse?
To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.
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.
How to make $300,000 as a nurse?
A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.
What does an RN utilization review do?
An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.
What is the difference between Utilization Review Rn vs Case Manager?
| Aspect | Utilization Review Rn | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, certifications in case management |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, community agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of care | Coordinating 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 make $150,000 as a nurse?
A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.
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.
What are the most commonly searched types of Utilization Review Rn jobs in McAllen, TX? The most popular types of Utilization Review Rn jobs in McAllen, TX are:
What are popular job titles related to Utilization Review Rn jobs in McAllen, TX? For Utilization Review Rn jobs in McAllen, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in McAllen, TX look for? The top searched job categories for Utilization Review Rn jobs in McAllen, TX are:
- Remote Utilization Review Nurse Practitioner
- Remote Utilization Review
- Remote Aetna Utilization Review Nurse
- Senior Rn Utilization Review Nurse
- Full Time Cigna Utilization Review Nurse
- Freelance International Utilization Review Nurse
- Contract Utilization Review
- Remote Optum Utilization Review
- Volunteer Navihealth Utilization Review
- Temporary Aetna Utilization Review Nurse
What cities near McAllen, TX are hiring for Utilization Review Rn jobs? Cities near McAllen, TX with the most Utilization Review Rn job openings:
Universal Health Services rating
6.8
Based on 252 frontline employees who took The Breakroom Quiz
495th of 886 rated healthcare providers
Job description
Responsibilities
POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible to help with the denial management process. There may be occasions when it will be necessary to work weekends, holidays, evenings, nights, and/or on-call/call-back status. Demonstrates Service Excellence standards at all times.
Qualifications
QUALIFICATIONS:
1. 1 years previous acute care RN experience required.
(Previous defined as: 'within the last three years')
2. Bilingual preferred (Spanish).
3. Experience in Health Care Coordination preferred.
4. Must demonstrate commitment and adherence to STHS's Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.
EDUCATION / LICENSURE:
1. Licensed in the State of Texas
2. Registered Nurse currently licensed in the State of Texas, or part of a compact state license, or has a valid temporary RN license for the State of Texas while waiting to receive the permanent license. BSN preferred.
3. Effective January 6, 2016, must possess an Associate Degree, Baccalaureate Degree or Diploma from a School of Nursing or University.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
Authorized by
Corporate Human Resources
POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible to help with the denial management process. There may be occasions when it will be necessary to work weekends, holidays, evenings, nights, and/or on-call/call-back status. Demonstrates Service Excellence standards at all times.
Qualifications
QUALIFICATIONS:
1. 1 years previous acute care RN experience required.
(Previous defined as: 'within the last three years')
2. Bilingual preferred (Spanish).
3. Experience in Health Care Coordination preferred.
4. Must demonstrate commitment and adherence to STHS's Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.
EDUCATION / LICENSURE:
1. Licensed in the State of Texas
2. Registered Nurse currently licensed in the State of Texas, or part of a compact state license, or has a valid temporary RN license for the State of Texas while waiting to receive the permanent license. BSN preferred.
3. Effective January 6, 2016, must possess an Associate Degree, Baccalaureate Degree or Diploma from a School of Nursing or University.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
Authorized by
Corporate Human Resources
What Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US