Dallas, TX · On-site
$27.25 - $36.50/hr
The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and ...
Dallas, TX · On-site
$27.25 - $36.50/hr
The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and ...
Certification in Case Management (CCM) or Utilization Review (ACM) strongly preferred * Familiarity with EPIC and MCG Indicia preferred * Minimum of 3 years of previous case management experience is ...
Certification in Case Management (CCM) or Utilization Review (ACM) strongly preferred * Familiarity with EPIC and MCG Indicia preferred * Minimum of 3 years of previous case management experience is ...
Certification in Case Management (CCM) or Utilization Review (ACM) strongly preferred * Familiarity with EPIC and MCG Indicia preferred * Minimum of 3 years of previous case management experience is ...
Certification in Case Management (CCM) or Utilization Review (ACM) strongly preferred * Familiarity with EPIC and MCG Indicia preferred * Minimum of 3 years of previous case management experience is ...
Certification in Case Management (CCM) or Utilization Review (ACM) strongly preferred * Familiarity with EPIC and MCG Indicia preferred * Minimum of 3 years of previous case management experience is ...
Certification in Case Management (CCM) or Utilization Review (ACM) strongly preferred * Familiarity with EPIC and MCG Indicia preferred * Minimum of 3 years of previous case management experience is ...
Dallas, TX · On-site +1
$299K - $395K/yr
Description Flexible Independent Contractor (1099) Opportunity Oral Surgeon for Utilization Review: Requires a DDS/DMD license in Texas, Minnesota, Oregon or Virginia/Maryland ABOUT MRIoA Founded in ...
Dallas, TX · On-site +1
$299K - $395K/yr
Description Flexible Independent Contractor (1099) Opportunity Oral Surgeon for Utilization Review: Requires a DDS/DMD license in Texas, Minnesota, Oregon or Virginia/Maryland ABOUT MRIoA Founded in ...
Irving, TX · On-site
Utilization Management (UM) nurses will provide our clients with appropriate and comprehensive ... Concurrent review and the determination of the extension of the length of stay based on the ...
Irving, TX · On-site
Utilization Management (UM) nurses will provide our clients with appropriate and comprehensive ... Concurrent review and the determination of the extension of the length of stay based on the ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Irving, TX · On-site
Utilization Management (UM) nurses will provide our clients with appropriate and comprehensive ... Concurrent review and the determination of the extension of the length of stay based on the ...
Irving, TX · On-site
Utilization Management (UM) nurses will provide our clients with appropriate and comprehensive ... Concurrent review and the determination of the extension of the length of stay based on the ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
$19.27 - $23.17
2% of jobs
$23.17 - $27.07
9% of jobs
$29.74 is the 25th percentile. Wages below this are outliers.
$27.07 - $30.97
21% of jobs
The median wage is $34.12 / hr.
$30.97 - $34.87
23% of jobs
$34.87 - $38.76
13% of jobs
$41.79 is the 75th percentile. Wages above this are outliers.
$38.76 - $42.66
10% of jobs
$42.66 - $46.56
8% of jobs
$46.56 - $50.46
5% of jobs
$50.46 - $54.35
5% of jobs
$54.35 - $58.25
2% of jobs
$58.25 - $62.15
2% of jobs
$19
$38
$62
A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.
A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.
To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.
The most popular types of Utilization Review jobs in Forney, TX are:
For Utilization Review jobs in Forney, TX, the most frequently searched job titles are:
The top searched job categories for Utilization Review jobs in Forney, TX are:
Cities near Forney, TX with the most Utilization Review job openings:
$27.25 - $36.50/hr
Part-time
Re-posted 11 days ago
This position will be hybrid in the Dallas, Texas area.
Part-time, working every other weekend.
This position requires availability to work alternating weekends and holidays as part of the regular schedule.
The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines. In addition, the UM LVN delegates to UM RN initial reviews and determines the medical necessity of requests by performing first level reviews. The UM LVN ensures a process that is efficient for providing care, ensuring timely and appropriate levels of care for the incoming patients. UM LVN is responsible for preparing cases for Physician Advisor for 2nd level review. This position will be hybrid with remote and in-office assignment.
SPECIFIC SKILLS NEEDED
