Top 28 Utilization review Jobs in Denton, Tx

Utilization Review Nurse
Bracane Co —Plano, TX
- Full-time
- Remote
- RN License
- Mid-level
- 3 years
Quick Apply
Case Manager - PRN
Select Rehabilitation Hospital of Denton —Denton, TX
- PRN
- Hospital
- Inpatient
- Mid-level
- Opportunities for advancement
Quick Apply
Personal Health Nurse - Remote
Conifer Care Continuum —Frisco, TX
- $64,168 - $96,262 a year
- Day shift
- Remote
- Microsoft Word
- Nursing
- RN License
- Health savings account
- AD&D insurance
9d
Intake Assessor
Ascent Healthcare Texas —Plano, TX
- $62,000 - $80,000 a year
- Full-time
- Licensed Clinical Social Worker
- LPC
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
14d
RN Utilization Review Coordinator, Full-time
Methodist Hospital for Surgery —Addison, TX
- Full-time
- CPR Certification
- Nursing
- RN License
Quick Apply
Clinical Utilization Nurse
CSI Pharmacy —Plano, TX
- $88,000 - $115,000 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Certified Nurse Practitioner
Quick Apply
8d
IDD Service Coordinator
Denton County MHMR Center —Denton, TX
- Full-time
- Writing skills
- Mid-level
- High school diploma or GED
Clinical Review Specialist
The Specialty Alliance —Southlake, TX
- $65,000 - $90,000 a year
- Full-time
- Nursing
- LVN
- 5 years
Quick Apply
Case Manager - FT
ClearSky Rehabilitation Hospital of Flower Mound, LLC —Flower Mound, TX
- Full-time
- Clean driving record
- Hospital
- Word processing
Quick Apply
7d
Staff Nurse Outpatient Clinic PHP/IOP CCFM
Carrus Health —Flower Mound, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
Staff Nurse Outpatient Clinic PHP/IOP CCF
Carrus Health —Frisco, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
Staff Nurse Outpatient Clinic PHP/IOP CCSL
Carrus Health —Southlake, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
Staff Nurse Outpatient Clinic PHP/IOP CCM
Carrus Health —McKinney, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
Staff Nurse Outpatient Clinic PHP/IOP CCK
Carrus Health —Keller, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
Mental Health Intake Specialist III
Denton County MHMR Center —Flower Mound, TX
- Full-time
- LMFT
- Psychiatry
- Licensed Clinical Social Worker
2d
RN CASE MANAGER
Horizon Rehabilitation Hospital —McKinney, TX
- Full-time
- Nursing
- OSHA
- RN License
3d
Patient Care Orders Specialist (LPN/LVN)
Elara Caring —Dallas, TX
- $55,000 - $60,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Outlook
- LVN
- Paid holidays
- Health insurance
Quick Apply
3d
Patient Care Representative
Elara Caring —Dallas, TX
- Weekends as needed
- Microsoft Outlook
- High school diploma or GED
- Home Health
- Paid holidays
- Health insurance
Quick Apply
3d
Home Health Clinical Manager
Centerwell —Plano, TX
- $77,200 - $106,200 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Paid holidays
Regional MDS Resource
PACS —Addison, TX
- $100,000 - $110,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- Basic math
Quick Apply
3d

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utilization review jobs near denton, tx

Utilization Review Nurse

Bracane Co -
Plano, TX

Quick Apply

Job Details

Full-time

Qualifications

RN License
Medical terminology

Full Job Description

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties***

JOB DESCRIPTION:

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.

JOB RESPONSIBILITIES:

This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions.
Collects clinical and non-clinical data.
Verifies eligibility.
Determines benefit levels in accordance to contract guidelines.
Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities.

JOB QUALIFICATIONS (Required):

Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations.
3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company.
Knowledge of medical terminology and procedures.
Verbal and written communication skills.

JOB QUALIFICATIONS (Preferred):

MCG or InterQual experience
Utilization management experience

LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin Counties).

POSITION: 6-month assignment

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Refine Your Search

utilization review jobs in denton, tx

Utilization Review Nurse

Case Manager - PRN

Personal Health Nurse - Remote

Intake Assessor

RN Utilization Review Coordinator, Full-time

Clinical Utilization Nurse

IDD Service Coordinator

Clinical Review Specialist

Case Manager - FT

Staff Nurse Outpatient Clinic PHP/IOP CCFM

Staff Nurse Outpatient Clinic PHP/IOP CCF

Staff Nurse Outpatient Clinic PHP/IOP CCSL

Staff Nurse Outpatient Clinic PHP/IOP CCM

Staff Nurse Outpatient Clinic PHP/IOP CCK

Mental Health Intake Specialist III

RN CASE MANAGER

Patient Care Orders Specialist (LPN/LVN)

Patient Care Representative

Home Health Clinical Manager

Regional MDS Resource

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