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

U.S. Renal Care

Dialysis Registered Nurse

Edinburg, TX · On-site

How you'll change lives As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of ... You'll ensure quality renal care by completing monthly reviews of patient medication profiles and ...

Driscoll

Valley Dialysis RN

Mcallen, TX

Please review the job information below. GENERAL PURPOSE OF JOB: The Dialysis RN is a professional Registered Nurse (RN) who provides direct nursing care to an assigned patient population, service ...

US Renal Care

Dialysis Registered Nurse

Edinburg, TX · On-site

How you'll change lives As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of ... You'll ensure quality renal care by completing monthly reviews of patient medication profiles and ...

U.S. Renal Care

Dialysis Registered Nurse

Edinburg, TX · On-site

How you'll change lives As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of ... You'll ensure quality renal care by completing monthly reviews of patient medication profiles and ...

Host Healthcare

RN - CVICU

Mcallen, TX · On-site

$890/wk

S. with an immediate option for this RN position in McAllen, TX. Sign-up here to submit your ... Reviews FROM REAL HOST HEALTHCARE TRAVELERS: "Host is the best travel agency. We have been using ...

Driscoll

Valley RN

Edinburg, TX

Please review the job information below. GENERAL PURPOSE OF JOB: The staff nurse (RN) is a professional Registered Nurse who provides direct nursing care to assigned patient population. The staff ...

UHS

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 ...

Vivian Health

Dialysis RN in Edinburg, TX

Edinburg, TX · On-site

Dialysis Registered Nurse Responsibilities: How you'll change lives As a Registered Nurse (RN) at ... You'll ensure quality renal care by completing monthly reviews of patient medication profiles and ...

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

Utilization Review Rn information

See McAllen, TX salary details

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$65

How much do utilization review rn jobs pay per hour?

As of Aug 8, 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 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 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 knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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:
What cities near McAllen, TX are hiring for Utilization Review Rn jobs? Cities near McAllen, TX with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in McAllen, TX as of August 2026, with employment types broken down into 4% As Needed, 84% Full Time, 4% Part Time, and 8% Contract. Highlights an 96% In-person, and 4% Remote job distribution, with an average salary of $83,551 per year, or $40.2 per hour.

Registered Nurse Progressive Care

Parkridge Medical Center

Mcallen, TX • On-site

Other

Posted 2 days ago

New

Job description

Registered Nurse Progressive Care

As the nation's largest private employer of Registered Nurses, we're honored by the trust of over 100,000 nurses and committed to supporting safe, high-quality care for which they can practice. That's why more than 80% of our hospitals earn an A or B Leapfrog safety grade, rank in the top 5% nationally for patient outcomes through Health Grades, or are recognized as Magnet or Pathway to Excellence facilities. Join us!

Job Summary and Qualifications

The Progressive Care Registered Nurse coordinates and delivers high quality, patient-centered care. In collaboration with medical providers, the RN provides pre-operative and post-operative nursing care. The RN serves as an advocate for patients to support an unparalleled patient experience.

What you will do in this role:

  • Assess patient condition during admission and during each shift, identifying and reporting any changes in patient status.
  • Perform procedures or other functions as ordered by the medical provider.
  • Document the administration of care in the patient medical record in a timely and thorough manner.
  • Perform the administration of prescribed medications and monitors response.
  • Maintain a knowledge of medications, procedures, and equipment used in the care of cardiac and medical-surgical patients.
What qualifications you will need:
  • Advanced Cardiac Life Spt must be obtained within 6 months of employment start date
  • Basic Cardiac Life Support must be obtained within 30 days of employment start date
  • (RN) Registered Nurse
  • Associate Degree, or Bachelors Degree

Rio Grande Regional Hospital in McAllen, Texas has been serving the Rio Grande Valley for more than 30 years. Our full service hospital has 320+ beds and a team of more than 500 physicians representing 35+ specialties. Rio Grande Regional Hospital offers a full range of inpatient and outpatient medical and surgical services. Our Emergency Room is a Level III Trauma Center and we have extended our ER services into the Rio Grande Valley with our three remote ERs in McAllen/Mission, Edinburg, and San Juan. Our Women's Services include L&D and a 30+ bed NICU. We also have an entire children's hospital within our main facility to care for the children in our community. We work with the Texas Transplant Institute, which serves local patients in need of organ, tissue or stem cell transplants. Our proven track record of serving the medical needs of the Valley communities we serve has led to Rio Grande Regional Hospital being recognized for patient safety and clinical excellence time and time again.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our Registered Nurse Progressive Care opening. Submit your application today and help advance the practice of nursing.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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