Impactful Utilization Review Nurse – RN (PRN)

UT Southwestern Department of Dermatology; Dallas (TX); Hybrid; USD 55,000 - 83,000; Full time

Benefits offered by this job

PPO medical plan

Paid Time Off

Tuition Reimbursement

Public Service Loan Forgiveness (PSLF)

Parental Leave

Job summary

UT Southwestern Medical Center in Dallas seeks an Utilization Review Nurse – RN PRN to conduct medical certification reviews for acute care. You will determine level of care and work with physicians to ensure appropriate utilization and documentation.

The role offers PRN hours Monday–Friday 8am–5pm, with hybrid location in Dallas and opportunities to collaborate across departments. Active Texas RN license and 5 years of experience are required, Epic CCM knowledge is preferred.

Qualifications

• Graduate of accredited nursing program with active Texas RN license.
• Minimum 5 years total experience, including 2 years in clinical settings and 3 years in utilization review.
• Experience with Epic CCM preferred.

Responsibilities

• Collaborates with Central Scheduling to obtain accurate clinical information for authorization.
• Reviews admissions for Medicare/Medicaid and private insurers using evidence-based guidelines.
• Determines level of care for inpatient vs observation based on documentation.
• Communicates with admitting physicians and physician advisors on care levels.
• Keeps current on regulatory changes affecting delivery and reimbursement.

Skills

RN license

Utilization review

Education

Nursing degree

Tools

Epic CCM

Job description

UT Southwestern Medical Center in Dallas seeks an Utilization Review Nurse – RN PRN to conduct medical certification reviews for acute care. You will determine level of care and work with physicians to ensure appropriate utilization and documentation.

The role offers PRN hours Monday–Friday 8am–5pm, with hybrid location in Dallas and opportunities to collaborate across departments. Active Texas RN license and 5 years of experience are required, Epic CCM knowledge is preferred.