Faith Stout

RN Outpatient Utilization Review Remote Texas HealthCare Support is actively seeking multiple Outpatient Utilization Review Registered Nurses with our prestigious Healthcare Client.  Applications must reside in Texas.  Houston, TX candidates are preferred.  Daily Responsibilities for RN Outpatient Utilization Review Remote Texas:

• Review telephonic and faxed clinical information to authorize medically necessary inpatient and outpatient care, utilizing nationally recognized evidenced based clinical criteria or approved medical guidelines. Refers cases that do not meet criteria to Medical Director for review.
•  Assists in discharge planning especially Home Health Nursing requests and DME requests for members at the time of discharge as well as new requests for members who have not had recent hospitalization. Review any requests for extension of these services and if not meeting criteria, refer to the Medical Director.
• Participates in Community Nursing Rounds if applicable with Medical Director and is adequately prepared. Assists co-workers with difficult cases through open discussion. Communicates concerns that arise in these discussions to the Manager and/or Medical Director.
•  Monday to Friday  8-5 six positions available Thurs- Sun 10 hr days six positions available

Required Qualifications for RN Outpatient Utilization Review Remote Texas:

• RN, current Texas License 
• 3 years of UR/UM
• Highlight lines of business worked- Texas Medicaid, CHIP, marketplace
• Highlight experience - was it inpatient or outpatient 
• Microsoft Office (Word, Outlook, Excel)

 Benefits for RN Outpatient Utilization Review Remote Texas:

• Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts
• Career and educational tools within our Ingenovis ACT (advocacy) Program

Pay Details: $38 - $42/ Hour Interested in Being Considered? If you are interested in applying to this position, please click Apply Now for immediate consideration. For additional questions, you may contact us at [email protected]. Please include your phone number, Job Title, and location and our recruiters will reach out. Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.