Texas Licensed Utilization Review Nurse

A company is looking for a Registered Nurse, Utilization Review - PRN M-F Days. Key Responsibilities Conduct medical certification reviews for acute care facility admissions based on evidence-based guidelines Collaborate with physicians and access management teams to ensure proper documentation and authorization Participate in performance improvement initiatives and maintain knowledge of regulatory changes affecting acute care services Required Qualifications Graduate of an accredited nursing program with an active RN license in Texas Minimum of 5 years of nursing experience, including 2 years of clinical and 3 years of Utilization Review experience Current experience using a medical necessity tool for utilization reviews Preferred acute care experience Basic computer skills and knowledge, with prior experience in Epic CCM preferred

Mar 24, 2025 - 16:20

A company is looking for a Registered Nurse, Utilization Review - PRN M-F Days. Key Responsibilities Conduct medical certification reviews for acute care facility admissions based on evidence-based guidelines Collaborate with physicians and access management teams to ensure proper documentation and authorization Participate in performance improvement initiatives and maintain knowledge of regulatory changes affecting acute care services Required Qualifications Graduate of an accredited nursing program with an active RN license in Texas Minimum of 5 years of nursing experience, including 2 years of clinical and 3 years of Utilization Review experience Current experience using a medical necessity tool for utilization reviews Preferred acute care experience Basic computer skills and knowledge, with prior experience in Epic CCM preferred