10 utilization management nurse jobs at 7 companies in Dallas, TX
2mo
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Utilization Review Nurse Health Plans - HP Utilization Management
Irving, Texas, United States
OnsiteFull Time
LVN required (state or compact), RN preferred; 3–5 years nursing experience preferred; proficiency with InterQual/MCG/CMS criteria, Microsoft Outlook/Teams/Word/Excel; strong communication and critical thinking; able to take after-hours calls.
InterQual, MCG, Centers for Medicare and Medicaid Services (CMS) Inpatient List, Microsoft Outlook, Microsoft Teams, Microsoft Word, Microsoft Excel
2mo
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Utilization Management LVN (Hybrid)
Dallas, Texas, United States
HybridFull Time
2+ YOEActive LVN licensure (or willingness to obtain, CA), 2+ years case management experience, knowledge of payer requirements, strong communication and organizational skills, proficiency with Microsoft Word/Excel/PowerPoint/Outlook, and ability to apply UM criteria.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Milliman Care Guidelines (MCG)
2mo
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Utilization Management RN (Hybrid)
Dallas, Texas, United States
HybridFull Time
2+ YOECurrent CA RN licensure or willingness to obtain, 2+ years bedside acute care, 2+ years case management, knowledge of payer requirements, strong communication and organizational skills, basic MS Office skills, ability to apply UM criteria, typing 50 WPM.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Milliman Care Guidelines (MCG)
1w
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UM Nurse Specialist, LVN (HYBRID)
Texas or Dallas
HybridFull Time
2+ YOEHigh school diploma/GED, active California LVN license or willingness to obtain, and 2+ years of utilization management experience in a health plan, managed care IPA, or medical group.
3mo
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Nurse Case Manager - Utilization Review - Mon, Tue, Sat, Sun
Fort Worth, Texas, United States
OnsiteFull Time
3+ YOERN with 3-5 years in clinical, case management, utilization review, or discharge planning; Bachelor's required; Texas RN licensure; ACM certification preferred; Master’s in Nursing preferred.
2mo
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Nurse Case Manager - Utilization Review - Nights (Fri-Sun, 7p-7a)
Fort Worth, Texas, United States
OnsiteFull Time
3+ YOEBachelor's in Nursing and active Texas RN license required; 3+ years clinical/case management/utilization review experience in acute care; ACM certification preferred; experience with discharge planning, assessment, documentation, and multidisciplinary collaboration.
21h
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Registered Nurse - Care Coordinator - Care Management
Dallas, Texas, United States
OnsiteFull Time
2+ YOEGraduate of an accredited nursing school with 2 years of hospital or community-based nursing experience; current Texas or compact RN license, BLS certification, care coordination, utilization review, and PC skills required.
PC, Windows
2w
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Nurse Care Manager
Dallas, Texas, United States
OnsiteFull Time
2+ YOERequires an active TX, AZ, or compact RN license and 2+ years as an RN plus 2+ years in case, chronic care, utilization, discharge, or transitions management. Strong communication, organization, data, EMR, and Microsoft Office skills required.
Microsoft Office, Electronic Medical Record
4d
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CASE MANAGER (FT)
Carrollton or Plano
OnsiteFull Time
2+ YOETwo years of case management experience required; nursing program graduation preferred. Requires medical terminology knowledge and preferably MDS, reimbursement, clinical utilization, or case management experience.
3mo
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Clinical Review Specialist (31389)
Southlake, Texas, United States
$65k-$90k/hr OnsiteFull Time
5+ YOENursing degree or diploma with LVN or RN in good standing, 5+ years nursing experience, 1+ year case management/utilization review, knowledge of CPT/ICD-10 and payer guidelines, strong communication and documentation skills.
CPT, ICD-10