AUSTIN TX Utilization Review RN

Bracane Company; Houston (TX); On-site; USD 48,000 - 55,000; Full time

Benefits offered by this job

401(k) Retirement Savings

Employee Assistance Program (EAP)

Financial Management Resources

Paid Time Off (PTO)

Paid Holidays

Job summary

Bracane Company in Austin, TX is seeking an Utilization Review RN to ensure patients receive the right care at the right time. You will conduct reviews, collaborate with physicians and care teams, and apply InterQual or Milliman criteria to support decisions.

The role requires an active Texas RN license, 2–3 years of clinical nursing experience, and experience in utilization review or managed care. You will work in a high-volume environment with strong analytical and communication skills.

Qualifications

• Active and unrestricted RN license in Texas.
• 2–3 years of clinical nursing experience.
• Prior utilization review or managed care experience preferred.

Responsibilities

• Conduct utilization review assessments for medical necessity and appropriateness of care.
• Perform concurrent, prospective, and retrospective reviews of patient cases.
• Collaborate with physicians and care teams to coordinate patient care plans.
• Apply InterQual or Milliman criteria to support review decisions.
• Document and communicate review findings accurately and timely.

Skills

RN license TEXAS

Analytical skills

Communication

Independent work

Education

Registered Nurse degree

Tools

InterQual

Milliman

Job description

About the Role

Bracane Company is seeking a dedicated and detail-oriented Utilization Review RN to join our team in Austin, TX. This is an exciting opportunity for a clinical professional to make a meaningful impact by ensuring patients receive the right care at the right time. If you're passionate about healthcare quality and patient advocacy, we want to hear from you!

Responsibilities

• Conduct utilization review assessments to evaluate medical necessity and appropriateness of care
• Perform concurrent, prospective, and retrospective reviews of patient cases
• Collaborate with physicians, case managers, and healthcare teams to coordinate patient care plans
• Apply evidence-based clinical criteria (e.g., InterQual, Milliman) to support review decisions
• Document and communicate review findings accurately and in a timely manner
• Identify opportunities for care improvement and ensure compliance with payer guidelines
• Support denial management and appeals processes as needed

Requirements

• Active and unrestricted RN license in the state of Texas
• Minimum 2-3 years of clinical nursing experience required
• Prior utilization review, case management, or managed care experience strongly preferred
• Familiarity with InterQual or Milliman clinical criteria
• Strong knowledge of medical terminology, coding, and payer guidelines
• Excellent analytical, communication, and critical thinking skills
• Ability to work independently and manage a high-volume caseload efficiently

About Us

Bracane Company is a trusted name in healthcare staffing and management solutions, committed to connecting top clinical talent with organizations that need them most. Our clients rely on us for our expertise, integrity, and dedication to quality care outcomes. At Bracane Company, employees thrive in a supportive environment that values their skills and invests in their professional growth.

Compensation

Compensation: $35.00 - $40.00 per hour

Equal opportunity

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Our Vision

Bracane Company, Inc. is a premier program management and research consulting firm. While our roots are deeply planted in clinical research and addressing health disparities, our global capabilities have expanded to deliver comprehensive operational support, compliance, and innovative solutions across federal, local government, and private sectors.

Our Mission

The mission of Bracane is to help our clients succeed by providing excellence and quality. We strive to deliver the best project management and operational support, ensuring our clients have access to the most innovative technologies, products, and services available globally. Supporting our clients supports our vision of a better future for all by advancing global research to create solutions for quality, efficient healthcare, clean water, and safe housing.

Work With the Best

At Bracane, we take a collaborative, high-standard approach to project execution. Whether managing public health compliance, technical data, or local infrastructure initiatives, our team is the backbone of our success. If you are looking to bring your expertise in project management, auditing, or coordination to a firm that values quality and community impact, explore our open career opportunities today.

Benefits

• 401(k) Retirement Savings: Plan for your future with our retirement savings program, designed to help you build long-term financial security.
• Employee Assistance Program (EAP): Access confidential, professional support for your mental, emotional, and personal well-being whenever you or your family need it.
• Financial Management Resources: Take advantage of tools and guidance to help you navigate your personal financial goals, budgeting, and investment planning.
• Paid Time Off (PTO): Reclaim your time, rest, and recharge with a flexible accrued paid time off policy.
• Paid Holidays: Enjoy dedicated time off to celebrate and spend with family and friends throughout the year.