RN Utilization Review jobs in Dallas, TX

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Clinical Health Liaison - Registered Nurse RN
Blue Cross Blue Shield 1,702 reviews - Richardson, TX
This position is involved in oversight of clinical health vendor agreements including review of adherence to contract requirements and may draft amendments to...
Sponsored by HCSC
RN CASE MANAGER - FT Days - $5000 Sign-on Bonus
Doctors Hospital at White Rock Lake 3 reviews - Dallas, TX
RN Case Manager -. Participating in weekly Complex Case Review. RN CASE MANAGER - FT Days - $5000 Sign-on Bonus....
Sponsored by Tenet Healthcare
Utilization Review Nurse
Multiple Location Third Party Payor Company - Dallas, TX
Experience in Utilization Review, Case Management or DM insurance preferred. Active RN License in Texas:....
Easily apply
Sponsored by Multiple Location Third Party Payor Company

Utilization Review RN

Baylor Scott & White Health 110 reviews - Dallas, TX
Reviews on all patients. The Utilization Review Nurse is a registered nurse who provides clinical review against standard criteria for the purpose of evaluating...

Registered Nurse (RN) - Utilization Management (UM) Nurse Co...

Aetna 551 reviews - Arlington, TX 76018 (Southeast area)
Utilization Management experience highly preferred. Click here to review the benefits associated with this position....

Regstered Nurse Case Manager PRN

The Medical Center of Plano - Plano, TX
Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity. Current licensure as an RN....

Care Coordinator UM/CM II

Blue Cross Blue Shield 1,702 reviews - Richardson, TX
Knowledge of clinical utilization management/case management activities and standardized criteria set. This position is responsible for performing concurrent...

Medication Nurse Reviewer

Cantex Continuing Care Network - Addison, TX
Daily review prior authorizations and coordinate the approval with documentation upon completion. Review new/readmissions in the electronic medical record (EMR)...
Easily apply

Case Manager - HIV

Resource Center Dallas 4 reviews - Dallas, TX
Prefer case management, utilization review, and/or discharge planning experience. RN acceptable, but must have current RN license or valid temporary license...

RN Care Coordinator Utilization Review

Baylor Scott & White Health 110 reviews - Dallas, TX
RN, BSN CCM or ACM certification 3+ years of acute inpatient case management / utilization review experience Strong Interqual knowledge....

Registered Nurse (RN) - Clinical Health Services Supervisor

Aetna 551 reviews - Dallas, TX 75207 (Near East area)
Application and/or interpretation of appropriate clinical criteria and guidelines to reviews. Candidate promotes communication, both internal and external, to...

Registered Nurse, Utilization Management Appeals

HealthSmart Care Management Solutions - Irving, TX
Clinical staff audits, appeal productivity analysis and review. Review all denials/appeals for approriate documentation and turn-around time....

Care Coordinator Registered Nurse

Parkland Health & Hospital System 224 reviews - Dallas, TX
Prefer case management, utilization review, and/or discharge planning experience. Must have current, valid RN license or temporary RN license from the Texas...
Healthy First Steps Utilization Management RN - Telecommute...
UnitedHealth Group 2,186 reviews - Dallas, TX
Utilization Management, case management, Utilization Review, Concurrent Review, Milliman. Perform utilization and concurrent review using Milliman/InterQual...
Sponsored by UnitedHealth Group
Employee Health Nurse
.. - Lewisville, TX
Oversee the appropriate utilization of employee health services and resources; Develop and revise policies and procedures as necessary and review policies and...
Sponsored by Adeptus Health

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