Utilization Review RN jobs in Dallas, TX

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Clinical Appeals RN - Telecommute
UnitedHealth Group 1,660 reviews - Dallas, TX
Utilization review, UR, utilization management, UM, TPA, managed care, insurance, concurrent review, appeals, provider appeals, member appeals, RN, Registered...
Sponsored by UnitedHealth Group - 19 days ago
Facility Based Behavioral Care Advocate - Richardson, TX
UnitedHealth Group 1,660 reviews - Richardson, TX
Administer benefits and review treatment plans. As a Behavioral/Mental Health Care Advocate you will be responsible for case management and utilization review...
Sponsored by UnitedHealth Group - 7 days ago

UM Nurse Consultant

Aetna 396 reviews - Arlington, TX 76017 (Southwest area)
The RN performs utilization review and management of bed days on Aetna Medicare members that are hospitalized in Skilled Nursing Facilities, Long Term Acute...
6 days ago - save job - email - more...

Utilization Review Nurse

UT Southwestern Medical Center - Dallas - Dallas, TX
Current TX RN license; Current CPR certification RN, BSN; Consistently relates utilization assessment to payers that are needed to justify continued stay review...
8 days ago - save job - email - more...

Utilization Review Nurse

AIG 387 reviews - Dallas, TX
Perform Utilization Review of workers' compensation claims, based on review criteria and protocols in accordance with state and regulatory agency compliance....
6 days ago - save job - email - more...

RN - CM/UM

Universal American (UAM) - Dallas, TX
Concurrent Review - telephonic review of medical necessity for elective admission and identification and referral when necessary for discharge planning....
1 day ago - save job - email - more...

Manager, Utilization Management

Centene Corporation 162 reviews - Dallas, TX
Compile and review multiple reports on work function activities for statistical and financial tracking purposes to identify utilization trends and make...
1 day ago - save job - email - more...

Utilization Management Nurse

HealthSmart Care Management Solutions - Irving, TX
Experience in Utilization Review, Case Management or DM and in insurance preferred. Provide pre-procedure, pre-admission, admission, concurrent and...
HealthSmart - 21 days ago - save job - email - more...

BH Clinical Appeals Reviewer

Blue Cross Blue Shield 1,319 reviews - Richardson, TX
Experience in Utilization Management or audit. Analyzes appeals data, determine appeals decisions or prepare cases for Medical Director review....
HCSC - 3 days ago - save job - email - more...

Utilization Manager

Centene Corporation 162 reviews - Dallas, TX
D or RN. 3+ years experience in psychiatric and/or substance abuse health care settings including utilization review....
1 day ago - save job - email - more...

RN Quality Accreditation Specialist

Christus Health 85 reviews - Irving, TX
Experience Recent (1-2 years) Quality Improvement experience in quality management, regulatory compliance, utilization review, risk management, information...
1 day ago - save job - email - more...

Registered Nurse (RN) - Utilization Management Nurse Consult...

Aetna 396 reviews - Arlington, TX 76018 (Southeast area)
Knowledge of managed care and utilization review preferred. RN with a current, unrestricted Texas license....
22 days ago - save job - email - more...
RN Field Case Managers-WellMed, Dallas, TX
UnitedHealth Group 1,660 reviews - Dallas, TX
Experience in utilization review, concurrent review and/or risk management. The RN Field Case Manager is responsible for utilization management and inpatient...
Sponsored by UnitedHealth Group - 20 days ago
RN - CASE MANAGER - PRN - DAYS
Doctors Hospital at White Rock Lake - Dallas, TX
RN - CASE MANAGER - PRN - DAYS. Participating in weekly Complex Case Review. We are currently seeking a PRN RN Case Manager....
Sponsored by Tenet Healthcare - 18 days ago
Manager Care Management for WellMed - Dallas, TX
UnitedHealth Group 1,660 reviews - Dallas, TX
Case manager, RN, manager case management, care manager, care management, CCM, managed care, rn manager, nurse manager, disease management, utilization...
Sponsored by UnitedHealth Group - 1 day ago

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