Utilization Review Nurse

Registered Nurse Utilization Review PRN Remote Why UT Southwestern? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees....

About Us At Baylor Scott & White Health, we support the health of people, families, and communities. Baylor Scott and White is Texas's largest not-for-profit healthcare system, encouraging healthy living. Our Core Values are: * We serve faithfully by doing what's right with a joyful heart. * We never settle by constantly striving for better. * We are in...

Job Description:As a Utilization Review Clinician at Elite, you will be responsible for evaluating medical treatment requests to determine their medical necessity. Using clinical expertise and evidence-based guidelines, you will review requests submitted by providers, requestors, claimants, or carriers to ensure they meet established standards. To be...

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...

About Us At Baylor Scott & White Health, we support the health of people, families, and communities. Baylor Scott and White is Texas's largest not-for-profit healthcare system, encouraging healthy living. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it...

HireOps Staffing LLC is seeking a highly skilled Utilization Review Medical Professional to join our team in Texas for a 6-month contract. This remote position involves assessing medical necessity and appropriateness of treatment plans using medically accepted criteria in the insurance or managed care industry.Job Description:The successful candidate will be...

About Us At Baylor Scott & White Health, we support the health of people, families, and communities. Baylor Scott and White is Texas's largest not-for-profit healthcare system, encouraging healthy living. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it...

HireOps Staffing LLC is seeking a skilled Clinical Review Nurse to join our team. This contract position offers a competitive salary of $40/hour, commensurate with experience.The successful candidate will possess 3 years of clinical experience in a physician office, hospital/surgical setting, or healthcare insurance company. Key skills include medical...

This is a contracted position that will start 01/02/2024 to 05/16/2025.Fully RemoteA RN or LPN/LVN responsible for annual patient chart inspection/audit. Audits are conducted to ensure that providers (MDs) accepting insurance are in compliance with standards of patient care set forth by the insurance company. Experience with medical record review...

Job Summary:We are seeking a skilled Clinical Review Specialist to join our team at Elite PC Services. As a key member of our utilization review team, you will be responsible for evaluating medical necessity and determining the appropriateness of treatments in Workers' Compensation cases.About the Role:Evaluate medical data and treatment requests to...

We are seeking an Orthopedic Reviewer to join our team at Dane Street, LLC in the Dallas or Houston area. As a Physician Reviewer, you will play a crucial role in analyzing medical records and applying CPT codes to ensure accurate determinations.Our company offers a competitive salary of $120,000 - $180,000 per year, depending on experience. We also provide...

Job Title: Medical Review SpecialistEstimated Salary:$120,000 - $150,000 per yearThe University of Texas Southwestern Medical Center is seeking a highly skilled Medical Review Specialist to join our team. As a key member of our healthcare quality assurance team, you will be responsible for conducting medical necessity reviews and ensuring that patients...

Job Description: Workers Compensation Utilization AnalystWe are seeking a detail-oriented Workers Compensation Utilization Analyst to join our team at Elite. In this role, you will be responsible for reviewing medical data to ensure the medical necessity of treatments for our Workers Compensation clients.Key Responsibilities:Evaluate medical data for...

Job Title: Registered Nurse - HEDIS AbstractorLocation: Remote or On-Site in the United StatesEstimated Salary: $70,000 - $90,000 per yearAbout HireOps Staffing LLCHireOps Staffing LLC is a leading healthcare staffing agency providing top talent to medical facilities across the United States.Job DescriptionThe Registered Nurse - HEDIS Abstractor will be...

This is a contract position starting on January 6th, 2025 and going until April 30th, 2025The position is fully remote. The pay is $40/hour for RN's. The pay is $37/hour for LPN/LVN.Review NurseSUMMARY DESCRIPTION:The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set...

Job Title:We are seeking a skilled Workers Compensation Utilization Manager to join our team at Elite PC Services. As a Clinical Review Specialist, you will be responsible for managing the utilization review process and ensuring compliance with industry standards.About the Role:Manage the utilization review process from intake to resolution.Ensure compliance...

Job DescriptionJob DescriptionWe are committed to providing exceptional products/services while maintaining a stellar reputation. As we continue to grow, we’re looking for talented individuals who are passionate about customer service, reviews, and analytics to help us stay at the forefront of our industry.Position Overview:We are seeking a dedicated...

Job DescriptionJob DescriptionWe are currently looking for a qualified candidate for a Locum to Permanent position. Our client is very responsive. Position Requirements:Must have an active Texas medical licenseBoard certification required in Family or Internal medicineClean medical background/recordInitially, the role will focus on making peer-to-peer phone...

Job Title: Utilities Project Engineer Job Description We are seeking a skilled and dedicated Utilities Project Engineer to assist with a Cooperative's Long Range Engineering Plan and Two-Year Work Plan. The ideal candidate will work closely with various engineering and operations managers to ensure the efficient and reliable delivery of electrical...

Our patients are our number one priority! We're committed to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - Hospital Additional Posting Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: Utilization Management supporting medical...