Top 8 Utilization review nurse Jobs in Ennis, Tx

Case Manager
Ennis Regional Medical Center —Ennis, TX
- Acute care
- Master of Social Work
- Nursing
3d
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Case Manager

Ennis Regional Medical Center -
Ennis, TX

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Job Details

3 days ago

Qualifications

Master's degree in social work
Patient care outcome improvement
Computer operation
Patient and family consultation
Master of Social Work
Nursing
Patient resource coordination
LSW
Medicare
Utilization review
Bachelor's degree in social work
LVN
Psychosocial assessment
Electronic health records (EHR) management
RN License
Interdisciplinary collaboration in health services social work
Health insurance policy knowledge
Nursing Diploma
Regulatory compliance
Licensed Clinical Social Worker
Social work
Patient advocacy
Mid-level
Community resource coordination in health services social work
Managing patients as a nurse case manager
Care planning in social services
Transitional care planning in clinical case management
Acute care facility experience
Overseeing care coordination
Medical-surgical

Full Job Description

Facility Ennis Regional Medical Center
Req ID 557651 Post Date 08/13/2026

Description

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Join Ennis Regional Medical Center in Ennis, TX, a full-service healthcare facility that provides an array of services, including advanced digital imaging, 24-hour emergency care, physical and occupational therapy, and same-day surgery. At Ennis, your daily contributions will contribute to a culture of high standards, meaningful impact, and local connection.

Job Summary

The Case Manager-Professional coordinates and facilitates the care of patients throughout the continuum of care in an acute-care hospital setting. The role involves effective collaboration and communication with Interdisciplinary Care Transitions (ICT) team members, physicians, patients, and families to ensure optimum utilization of resources, service delivery, and compliance with external review agencies. The Case Manager-Professional conducts comprehensive assessments, develops care plans, implements and evaluates interventions to enhance patient management, promote continuity of care, and support cost-effective outcomes.

Essential Functions

Coordinate clinical and psycho-social activities with the Interdisciplinary Team to provide comprehensive care coordination and discharge planning.
Conduct comprehensive biopsychosocial assessments to provide timely and safe discharge planning, referring cases to Social Workers as applicable.
Monitor patient care to ensure effective coordination and efficient care facilitation from admission through discharge.
Perform medical necessity reviews and assess the appropriateness of clinical resource utilization.
Develop and implement discharge plans that address both immediate and post-discharge needs, coordinating with community resources as needed.
Serve as a patient advocate, promoting informed decision-making and maximizing patient and family understanding of care plans.
Participate in interdisciplinary patient care rounds and conferences to review treatment goals and optimize resource utilization.
Maintain accurate documentation of patient care, discharge planning activities, and third-party payor reviews according to regulatory requirements.
Stay informed about government and non-government payor practices, regulations, standards, and reimbursement policies.

Knowledge/Skills/Abilities/Expectations

Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
Knowledge of Medicare benefits and insurance processes and contracts.
Excellent interpersonal, verbal, and written communication skills to effectively interact with patients, families, and healthcare providers.
Strong organizational and critical thinking skills to manage multiple patient cases simultaneously.
Basic computer skills, including proficiency in Microsoft Office Suite and electronic medical records systems.
Ability to work collaboratively within a multidisciplinary team to achieve optimal patient outcomes.
Must maintain regular attendance and adhere to hospital policies and procedures.

Qualifications

Education

Postsecondary (Certificate, Diploma, or Program Graduate) – RN or LPN/LVN Diploma, Associate’s, or Bachelor’s Degree from an accredited school of nursing (required) OR

Bachelor’s Degree or higher in Social Work (BSW or MSW) (required)

Licenses/Certifications

LPN or LVN – Licensed Practical or Vocational Nurse – State Licensure in the state of practice upon hire (required) OR

RN – Registered Nurse – State Licensure and/or Compact State Licensure in the state of practice upon hire (required) OR

LCSW – Licensed Clinical Social Worker or LSW in the state of practice upon hire (required)

Experience

One (1) or more years of experience in a healthcare setting, with experience in case management, utilization review, or discharge planning (preferred)

Prior experience in acute care, medical/surgical, or ICU/CCU settings (preferred)

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utilization review nurse jobs in ennis, tx

Case Manager

Case Manager ( RN / RT / SW / LPN )

CSCD JTC LVN

Appeals Professional III (Licensed Clinician)

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