Utilization Review Nurse Jobs in Dallas, Texas

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439 Dallas, TX Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 439
Modis, Inc. Richardson, TX
Job Responsibilities Hi Are you seeking unparalleled growth in a sky the limit environment? This UTILIZATION REVIEW NURSE position is calling your name. A UTILIZATION REVIEW NURSE is needed for a recognized industry leader, who invests heavily in internal technologies. Our clients is experiencing explosive growth in a billion dollar industry and continues and to receive industry awards and accola...
Baylor Health care Dallas, TX
The Utilization Review Nurse provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with health plan utilization departments regardin...
Baylor Health care Dallas, TX
The Utilization Review Nurse provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with health plan utilization departments regardin...
Baylor Health Care System DALLAS, TX
Description The Utilization Review Nurse provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with health plan utilization departm...
Baylor Health care Dallas, TX
The Utilization Review Nurse provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with health plan utilization departments regardin...
Baylor Health Care System DALLAS, TX
Description The Utilization Review Nurse provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with health plan utilization departm...
The Utilization Review Nurse provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with health plan utilization departments regardin...
The Utilization Review Nurse provides clinical review against standard criteria for the purpose of evaluating medical necessity, regardless of payor type. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with health plan utilization departments regardin...
HealthCare Scouts, Inc. Irving, TX
We are currently hiring for multiple Nurse Case Management and Utilization Review positions working with a Fortune 500 organization. This company boasts over three decades of specialization in the managed care arena with a strong emphasis on providing quality healthcare in the Dallas/Fort Worth area. As a Registered Nurse (RN) Case Manager, you will be responsible for developing a quality, cost ef...
Christus Health Irving, TX
« back to search results Apply Now RN Utilization Review -Corp USFHP Position Summary: This position is responsible for analyzing clinical information submitted by medical providers to evaluate the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Is responsible for clinical review of all requested services for appropriateness based on clinical...
Christus Health Irving, TX
« back to search results Apply Now RN Utilization Review -Corp USFHP Position Summary: This position is responsible for analyzing clinical information submitted by medical providers to evaluate the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Is responsible for clinical review of all requested services for appropriateness based on clinical...
HealthCare Scouts, Inc. Dallas, TX
If you are looking to expand your horizons and put your skills to work for one of the most influential Fortune 500 companies in the US, look no further. Our select client is looking for a Director of Utilization Review in the Dallas, TX area. As the Director of Utilization Review, you will focus on managing the day to day operations and evaluation of daily data capture, quality assurance, program ...
Baylor Health Care System DALLAS, TX
Description Manager Utlization Review The Manager of Clinical Resource Management provides direct oversight for Utilization Review (UR) and the Denial Resource Center (DRC). This includes staffing, budget maintenance, performance management and overall support for these departments. Establishes and monitors departmental goals and objectives consistent with BSWH Revenue Cycle and BSWH strategic ...
Baylor Health Care System DALLAS, TX
Description Manager Clinical Resource Management Manager Clinical Resources Management provides direct oversight for Utilization Review (UR) and the Denial Resource Center (DRC). This includes staffing, budget maintenance, performance management and overall support for these departments. Establishes and monitors departmental goals and objectives consistent with BSWH Revenue Cycle and BSWH strat...
Manager Utlization Review The Manager of Clinical Resource Management provides direct oversight for Utilization Review (UR) and the Denial Resource Center (DRC). This includes staffing, budget maintenance, performance management and overall support for these departments. Establishes and monitors departmental goals and objectives consistent with BSWH Revenue Cycle and BSWH strategic objectives, m...
RN or LCSW Utilization Management Representative – Behavioral Health Managed Care Dallas, TX Your Job Summary: As a member of the medical management team, the Behavioral Health Utilization Management Representative is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review of care, related to mental health or substance abuse issues. The...
Description: Clinical Coverage Review Medical Director The Medical Director provides physician support to Clinical Coverage Review (CCR) operations, the organization responsible for the initial clinical review of service requests for UnitedHealth Care (UHC). The Medical Director collaborates with CCR leadership and staff to establish, implement, support and maintain clinical and operational proc...
UnitedHealth Group Inc Dallas, TX
Position Description There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management Nurs...
UnitedHealth Group Inc Richardson, TX
Position Description Preservice Review Nurse This position is OFFICE BASED with M - F daytime hours 1311 W PRES GEORGE BUS HWY RICHARDSON, TX 55310 The Preservice Review RN (heavy DME) will be responsible for: Assesses and interprets member needs and requirements Provides authorizations and/or denials based on clinical documentation review and medical necessity Collaborates closely with th...
RN - UTILIZATION MANAGEMENT Dallas, TX Duties: Come join our professional team of providers in our Patient Administrative Service! The Utilization Management (UM) Nurse provides direct staff support to service chiefs, and others in planning,designing, implementing, modifying, and administering a patient flow and throughput program which is used to evaluate and improve quality, timeliness and a...

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