Top 29 Utilization review nurse Jobs in Mansfield Tx

Utilization Review Nurse
Oscar Health —Dallas, TX
- $35.00 - $45.94 an hour
- Weekends as needed
- Remote
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Paid holidays
Quick Apply
2d
RN/SW Case Manager
Texas Health Hospital Mansfield —Mansfield, TX
- $24.47 - $62.59 an hour
- Full-time
- Microsoft Outlook
- Customer service
- Computer literacy
- Paid parental leave
- Disability insurance
Staff Nurse Outpatient Clinic PHP/IOP CCMF
Carrus Health —Mansfield, TX
- RN License
- Computer literacy
- BLS Certification
Quick Apply
Utilization Management RN (Hybrid)
TEXASCONNECT INC —Dallas, TX
- Weekends as needed
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Relocation assistance
Nurse Case Manager - Utilization Review - (Mon, Tue, Sat, Sun, 12p-10p)
JPS Health Network —Fort Worth, TX
- Full-time
- Nursing
- RN License
- Inpatient
Nurse Case Manager - Utilization Review - Nights (Fri-Sun, 7p-7a)
JPS Health Network —Fort Worth, TX
- Full-time
- Nursing
- RN License
- Inpatient
Clinical Review QC Auditor
CorVel Corporation —Fort Worth, TX
- $68,566 - $104,841 a year
- Full-time
- Remote
- LVN
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Utilization Management LVN (Hybrid)
TEXASCONNECT INC —Dallas, TX
- Weekends as needed
- Hybrid work
- Microsoft Outlook
- LVN
- Computer literacy
- Relocation assistance
PRN Case Manager
ClearSky Rehabilitation Hospital of Mansfield, LLC —Mansfield, TX
- 8 hour shift
- Clean driving record
- Hospital
- Word processing
Quick Apply
Case Manager
ClearSky Rehabilitation Hospital of Mansfield, LLC —Mansfield, TX
- Full-time
- Clean driving record
- Hospital
- Word processing
Quick Apply
2d
Case Manager II PRN Days
Kindred Hospital Tarrant County - Arlington —Arlington, TX
- PRN
- Master of Social Work
- Nursing
- RN License
Medical Field Case Manager
Enlyte —Arlington, TX
- $68,000 - $75,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
3d
RN, Case Manager, Inpatient (PRN)
Cook Children's Health Care System —Fort Worth, TX
- Part-time
- Spanish
- Nursing
- RN License
RN, Case Manager of Homeless Initiative
Cook Children's Health Care System —Fort Worth, TX
- Part-time
- Spanish
- Nursing
- RN License
Registered Nurse (RN) - Case Manager - PRN
Texas Health Resources —Arlington, TX
- Weekends as needed
- Nursing
- RN License
- Hospital
- 401(k)
- Paid time off
14d
Care Coordinator RN
Children's Health —Dallas, TX
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Itemization Review Supervisor
CorVel Corporation —Fort Worth, TX
- $70,276 - $116,942 a year
- Full-time
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health savings account
- Disability insurance
Quick Apply
8d
Advanced Practice Provider (Physician Assistants & Nurse Practitioners)
CITYDOC —Fort Worth, TX
- $70 - $75 an hour
- Full-time
- Spanish
- Urgent Care
- English
Quick Apply
Home Health Nurse
Your Tailor Made Senior Service —Fort Worth, TX
- Part-time
- LVN
- RN License
- Computer literacy
Quick Apply

More jobs to discover

Find similar jobs that you might be interested in.

RN/SW Case Manager
Texas Health Hospital Mansfield —Mansfield, TX
Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors…
$24.47 - $62.59 an hour

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence. Exp. in the delivery of a health services program or…
$40.40 an hour
3d
Patient Support Nurse
Valeris, Inc. —Columbus, OH
Must have active RN licensure in current state of practice. 2-3 years of nursing experience with relevant disease state experience preferred.
Quick Apply
1d

Show more jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in mansfield tx

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review nurse jobs near mansfield tx

Utilization Review Nurse

Oscar Health -
Dallas, TX

Quick Apply

Job Details

$35.00 - $45.94 an hour
2 days ago

Benefits

Paid parental leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
Parental leave
Vision insurance
Paid sick time

Qualifications

Nursing
Utilization review
Managed care organization experience
Acute care facility experience
Utilization management
Decision making
Resource utilization in healthcare
Milliman Care Guidelines (MCG Health)
Nursing

Full Job Description

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.

About the role:

You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

You will report into the Supervisor, Utilization Review.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
Meet required decision-making SLAs
Refer members for further care engagement when needed
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
Ability to obtain additional state licenses to meet business needs
1+ year of utilization review experience in a managed care setting
Strong experience utilizating MCG (Milliman Care Gudielines)
1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)
Weekend availability is required; all applicants must be able to work at least one weekend day (Saturday or Sunday) each week.

Bonus points:

BSN
Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care - an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Quick Apply

Refine Your Search

utilization review nurse jobs in mansfield tx

Utilization Review Nurse

RN/SW Case Manager

Staff Nurse Outpatient Clinic PHP/IOP CCMF

Utilization Management RN (Hybrid)

Nurse Case Manager - Utilization Review - (Mon, Tue, Sat, Sun, 12p-10p)

Nurse Case Manager - Utilization Review - Nights (Fri-Sun, 7p-7a)

Clinical Review QC Auditor

Utilization Management LVN (Hybrid)

PRN Case Manager

Case Manager

Case Manager II PRN Days

Medical Field Case Manager

RN, Case Manager, Inpatient (PRN)

RN, Case Manager of Homeless Initiative

Registered Nurse (RN) - Case Manager - PRN

Care Coordinator RN

Itemization Review Supervisor

Advanced Practice Provider (Physician Assistants & Nurse Practitioners)

Home Health Nurse

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in mansfield tx

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected