Utilization Review Nurse (RN), Remote in Texas
Employment type
Full-time
Work setting
On-site
Location
Plano, TX
Schedule
Day shift
Posted
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Job overview
The Utilization Review Nurse (RN), Remote in Texas role is remote for candidates based in the Austin area (Travis/Williamson Counties) or Richardson area (Dallas/Collin Counties). Compensation is not specified. The nurse works in the insurance or managed-care industry, reviewing medical necessity and treatment-plan appropriateness. The role conducts utilization reviews and discharge care coordination, evaluates clinical and non-clinical information, and serves as a liaison between providers and medical and network management divisions. This work supports efficient, effective, and quality medical and surgical services.
What you'll do
- Perform initial and concurrent review activities
- coordinate discharge care
- collect clinical and non-clinical data
- verify eligibility
- determine benefit levels under contract guidelines
- provide members, providers, and facilities with information about utilization-management requirements and procedures
- liaise between providers and medical and network management divisions.
What we're looking for
- Skills & competencies
- utilization review nurseregistered nursernremote in texasaustin areatravis countywilliamson countyrichardson areadallas countycollin countymedical necessitysix-month assignment
- Work arrangement
- Weekend coverage required
Why this role
Six-month assignment; remote work is limited to candidates based in specified Texas counties.
About the employer
Bracane Co is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.
Additional details
- Industry sector
- 52
- Industry
- Direct Health and Medical Insurance Carriers
- Occupation code
- 29-1141.00
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Listing ID: b7611272-f00b-446c-b993-e95c59e287f4