Current jobs related to Utilization Review RN - Dallas - HireOps Staffing LLC

  • Utilization Review Registered Nurse

    3 weeks ago

    Dallas, Texas, United States Care Full time

    Utilization Review Registered Nurse - REMOTEPosition Overview:The Utilization Review Registered Nurse is responsible for ensuring that appropriate medical necessity documentation is maintained for inpatient status or observation placements. This role involves effective communication with physicians and healthcare providers to ensure timely submission of...

  • Utilization Review Registered Nurse

    4 weeks ago

    Dallas, Texas, United States Care Full time

    Utilization Review Registered Nurse - REMOTEPosition Overview:The Utilization Review Registered Nurse plays a pivotal role in ensuring the appropriate medical necessity documentation for inpatient admissions or observation placements. This position requires effective communication with physicians and clinical staff to guarantee timely submission of clinical...

  • Utilization Review Registered Nurse

    3 weeks ago

    Dallas, Texas, United States Care Full time

    Utilization Review Registered Nurse - REMOTEPosition Overview:The Utilization Review Registered Nurse is responsible for ensuring the documentation of medical necessity for inpatient admissions or observation placements. This role involves effective communication with physicians and healthcare providers to guarantee timely submission of clinical information...

  • Registered Nurse Utilization Review Specialist

    3 weeks ago

    Dallas, Texas, United States University of Texas Southwestern Medical Center Full time

    Job SummaryWe are seeking a highly skilled Registered Nurse to join our team as a Utilization Review Specialist. In this role, you will be responsible for conducting medical certification reviews to determine the medical necessity of acute care services.Key ResponsibilitiesConduct inpatient admission reviews for Medicare and Medicaid beneficiaries, as well...

  • Healthcare Utilization Review Specialist

    4 weeks ago

    Dallas, Texas, United States AmTrust Financial Services, Inc. Full time

    Overview:AmTrust Financial Services, a rapidly expanding commercial insurance provider, is seeking a Healthcare Utilization Review Specialist for remote or office-based work.PRIMARY PURPOSE:The Healthcare Utilization Review Specialist is tasked with evaluating the medical necessity, suitability, quality, and efficiency of services provided to Workers'...

  • Utilization Review Registered Nurse

    3 weeks ago

    Dallas, Texas, United States Care Full time

    Utilization Review Registered Nurse - REMOTEPosition Overview:The Care Manager is accountable for ensuring the documentation of medical necessity for inpatient admissions or observation placements is accurate and timely. This role involves effective communication with physicians and clinical staff to facilitate the authorization process with payors.Key...

  • Utilization Review Registered Nurse

    3 weeks ago

    Dallas, Texas, United States Steward Health Care Full time

    Position Overview at Steward Health CareThe Clinical Care Manager is primarily accountable for documenting the medical necessity for inpatient admissions or observation placements. This role involves close collaboration with physicians and healthcare providers to ensure that clinical data is swiftly communicated to payers for patient authorization during...

  • Utilization Review Nurse

    1 month ago

    Dallas, United States Elite PC Services Full time

    Utilization Review Nurse for Workers' Comp Job Purpose: Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines. Duties: Perform an evaluation of the medical data for utilization review...

  • Clinical Review Nurse

    7 days ago

    Dallas, Texas, United States AmTrust Financial Full time

    Job SummaryWe are seeking a skilled Clinical Review Nurse to join our team at AmTrust Financial Services. As a Clinical Review Nurse, you will play a critical role in reviewing medical necessity, appropriateness, quality, and efficiency of services for Workers' Compensation claimants.Key ResponsibilitiesPerform utilization review activities prospectively,...

  • Utilization Review Registered Nurse

    4 weeks ago

    Dallas, Texas, United States Steward Health Care Full time

    Position Overview at Steward Health CareThe Clinical Care Management RN is primarily responsible for documenting the medical necessity for inpatient admissions or observation placements. This role involves collaborating with physicians and healthcare providers to ensure that clinical information is efficiently communicated to payers for patient...

  • Utilization Review Registered Nurse

    4 weeks ago

    Dallas, Texas, United States Steward Health Care Full time

    Clinical Care Manager Role at Steward Health CareThe Clinical Care Manager is primarily accountable for documenting the medical necessity for inpatient admissions or observation placements. This role involves collaboration with physicians and healthcare providers to ensure that clinical information is efficiently communicated to payers for patient stay...

  • staff - Utilization Review at Children's Health (Dallas) - 3x12 hrs - Registered Nurse (RN)

    4 days ago

    Dallas, United States Children's Health (Dallas) Full time

    Children's Health (Dallas) is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Dallas, Texas.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNDuration: Ongoing36 hours per weekShift: 12 hoursEmployment Type: Staff Job Title & Specialty Area:  Utilization Management RNDepartment: Utilization ReviewLocation:...

  • Clinical Review Specialist for Workers' Compensation

    3 weeks ago

    Dallas, Texas, United States Elite Full time

    Job SummaryWe are seeking a highly skilled Utilization Review Nurse to join our team at Elite. As a key member of our clinical review team, you will play a critical role in ensuring the medical necessity of treatment requests submitted by providers, requestors, claimants, or carriers.Key ResponsibilitiesMedical Necessity Review: Conduct thorough evaluations...

  • Utility

    4 weeks ago

    Dallas, United States Dallas County Full time

    Provides technical assistance to the Chief Utility Relocation Manager and the Utility Designer. Assists with the collection of data for plotting franchise utility locations (approximate) in the area of proposed construction. Collection includes (upload/download) plans from the franchise utility companies using such platforms as Dropbox, U-Serve, etc. Assists...

  • HEDIS Review Nurse Specialist

    7 days ago

    Dallas, Texas, United States HireOps Staffing LLC Full time

    HEDIS Review Nurse Job DescriptionThis is a contracted position that will involve remote work. As a Registered Nurse (RN) or Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) with an unrestricted license in the state, you will be responsible for annual patient chart inspection/audit. The audits are conducted to ensure that providers (MDs)...

  • Physician Reviewer

    2 weeks ago

    Dallas, Texas, United States Dane Street, LLC Full time

    Job Opportunity at Dane Street, LLCJob Title: Physician ReviewerJob Summary:Dane Street, LLC is seeking a highly skilled Physician Reviewer to join our team. As a Physician Reviewer, you will utilize your clinical expertise to review insurance appeals, prospective and retrospective claims, and provide an interpretation of the medical necessity of services...

  • Pre-Service Review Coordinator

    3 weeks ago

    Dallas, Texas, United States UnitedHealth Group Full time

    About the RoleWe are seeking a highly skilled and experienced Pre-Service Review Coordinator to join our team at UnitedHealth Group. As a key member of our clinical review team, you will play a critical role in ensuring the medical appropriateness of pre-authorization requests.Key ResponsibilitiesReview and determine medical appropriateness of...

  • Utilities Estimator

    1 month ago

    Dallas, United States Hays Full time

    Senior Estimator - Wet UtilitiesJob Summary: The Senior Estimator is responsible for preparing accurate and competitive cost estimates for wet utility projects, including water and sewer for commercial and residential construction projects. This role involves analyzing project plans, specifications, and other documentation to prepare time, cost, materials,...

  • Utilization Management Nurse

    2 weeks ago

    Dallas, Texas, United States Parkland Health & Hospital System Full time

    About the RoleParkland Health & Hospital System is seeking a skilled Utilization Management Nurse to join our team. As a Utilization Management Nurse, you will play a critical role in ensuring that our members receive the most appropriate and effective care possible.Key ResponsibilitiesPerform utilization review activities, including pre-certification,...

  • Clinical Review Specialist II

    2 weeks ago

    Dallas, Texas, United States CorVel Corporation Full time

    Job SummaryCorVel Corporation is seeking a highly skilled Clinical Review Specialist II to join our team. As a Clinical Review Specialist II, you will play a critical role in ensuring the medical necessity of in-patient admissions and out-patient treatment, while supporting the goals of our Case Management department.Key ResponsibilitiesConduct thorough...

Utilization Review RN

4 months ago

Dallas, United States HireOps Staffing LLC Full time
This position is fully remote, however, you must reside in the State of Texas

The position is a contract for about 6 months.

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