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

Supports evidence-based practice changes through research utilization and experiential learning ... (RN) Basic Life Support (BLS): BLS or BLS within 30 days of hire or transfer. Employment Type ...

Reviews and revises plan of care according to change in patient's status. Incorporates patient ... The RN uses the BSWH nursing model to coordinate patient care. Using the nursing process, the RN ...

Reviews and revises plan of care according to change in patient's status. Incorporates patient ... The RN promotes safe passage for patients by using knowledge of patient needs. The RN helps ...

Registered Nurse Under the general supervision of the Director of Nursing, and Assistant Director ... Ensuring the ordering, reviewing, monitoring, discontinuation and, if necessary, the disposal of ...

Showing results 41-60

Utilization Review Rn information

See Waco, TX salary details

$18

$37

$61

How much do utilization review rn jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for utilization review rn in Waco, TX is $37.54, according to ZipRecruiter salary data. Most workers in this role earn between $29.66 and $43.12 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 Waco, TX? The most popular types of Utilization Review Rn jobs in Waco, TX are:
What are popular job titles related to Utilization Review Rn jobs in Waco, TX? For Utilization Review Rn jobs in Waco, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Waco, TX look for? The top searched job categories for Utilization Review Rn jobs in Waco, TX are:
What cities near Waco, TX are hiring for Utilization Review Rn jobs? Cities near Waco, TX with the most Utilization Review Rn job openings:
Infographic showing various Utilization Review Rn job openings in Waco, TX as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, and 4% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $78,075 per year, or $37.5 per hour.

Full-time

Medical, Retirement, PTO

Re-posted 21 days ago


Baylor Scott & White Health rating

7.5

Company rating: 7.5 out of 10

Based on 757 frontline employees who took The Breakroom Quiz

232nd of 887 rated healthcare providers


Job description

JOB SUMMARY
The Registered Nurse (RN) Float is a licensed professional who uses the BSWH nursing professional practice model to coordinate patient care delivery by the health care team. Using the nursing process, the RN assesses the patient, identifies nursing diagnoses based on responses to health problems, develops and implements an individualized plan of care, and evaluates the patient's response. The RN promotes safe passage for their patients by using knowledge of patient needs and the healthcare environment to assist patients to transition through the healthcare encounter without any preventable complications or delays. The RN delegates interventions to health care personnel based on the Texas Nursing Practice Act, each patient's condition and the competencies of the employee.
ESSENTIAL FUNCTIONS OF THE ROLE
Clinical Judgment: Using clinical reasoning, conducts accurate clinical assessments according to practice standards. Identifies and prioritizes patient and family needs. Develops, implements and evaluates the nursing plan of care. Modifies plan to meet clinical outcomes.
Clinical Inquiry: Systematically evaluates the quality and effectiveness of nursing practice, including, but not limited to, nursing sensitive indicators. Supports evidence-based practice changes through research utilization and experiential learning. Participates in quality/performance improvement initiatives.
Caring Practices: Creates a compassionate, supportive, safe and therapeutic environment for patients, families and staff. Develops therapeutic relationships with patient and family and maintains appropriate boundaries. Manages both emotional and physical pain with the aim of promoting comfort and healing and preventing unnecessary suffering.
Response to Diversity: Recognizes, appreciates and incorporates a patient's and family's unique differences, such as culture, spiritual beliefs, gender, race, ethnicity, lifestyle, socioeconomic status, age, and values, into an individualized plan of care.
Advocacy and Moral Agency: Preserves and protects the confidentiality, autonomy, dignity and rights of patient and family and represents their concerns. Creates an individualized plan that accurately reflects patient and family values and goals. Identifies and helps resolve ethical and clinical concerns.
Facilitation of Learning: Facilitates learning for patients and families, nursing staff, other members of the health care team and community; integrating appropriate education throughout the continuum of care to help them participate and/or make informed decisions about their health care and treatments, including health promotion and disease prevention. Assesses and documents learning needs and outcomes.
Collaboration: Works collaboratively and interdependently with colleagues and community to develop and implement an integrated plan of care. Open and sensitive to all team members' unique contributions. Delegates tasks and care to appropriate staff and ensures timely follow-up.
Systems Thinking: Uses strategies and available resources for problem-solving for patients, family and staff. Recognizes that resources are limited and considers factors related to safety, effectiveness and efficiency in planning and delivering patient care.
Professionalism: Improves nursing practice and the work environment through participating in shared governance and decision-making processes and meaningfully recognizing the contributions of others. Participates in the staffing process from education and planning to evaluation. Identifies personal goals and commits to ongoing professional growth through continuing education, networking with professional colleagues, membership and involvement in professional nursing organizations, self-study, professional reading, certification and seeking advanced degrees. Contributes to the professional development of peers, colleagues and others. Demonstrates commitment to community service.
KEY SUCCESS FACTORS
Knowledge and understanding of nursing and patient care standards and procedures.
Knowledge of laws, rules and regulations; standards and guidelines of certifying and accrediting bodies; hospital and department/unit standards, protocols, policies and procedures governing the provision of nursing care applicable to the area of assignment.
Knowledge of medical terminology; principles and practices of health promotion, risk reduction, illness and disease prevention and management; medications and drugs, common dosages, their physical and physiological effects, and possible adverse reactions.
Knowledge of medical and professional nursing ethics and patient privacy rights.
Must be able to communicate thoughts clearly, both verbally and in writing.
Interpersonal skills to interact with a wide-range of constituencies.
Must have critical thinking and problem-solving skills.
Ability to observe changes in the medical condition of patients and effectively communicate these changes to other nursing staff members and physicians/providers.
Ability to provide age-specific, quality, patient-centered care to all patients through the nursing process and standards of nursing practice with sensitivity and respect for the diversity of human experience and to develop, evaluate, implement and, as necessary, modify a patient care plan to meet the needs of individual patients.
General computer skills, including but not limited to: Microsoft Office, information security, scheduling and payroll systems, electronic medical documentation, and email.
BENEFITS
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
- EDUCATION - Grad of an Accredited Program or 2 years of work experience above the minimum qualification
- MAJOR - Nursing
- MAJOR - Nursing
- MAJOR - Nursing
- EXPERIENCE - 1 Year of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
      &nbspRegistered Nurse (RN)
      &nbspBasic Life Support (BLS): BLS or BLS within 30 days of hire or transfer.

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