PRN Utilization Review RN – Weekends

UT Southwestern Medical Center; Dallas (TX); On-site; USD 55,000 - 83,000; Part time

Benefits offered by this job

PPO medical plan

Paid Time Off

Retirement Programs

Paid Parental Leave

Wellness programs

Tuition Reimbursement

PSLF Qualified Employer

Job summary

UT Southwestern Medical Center in Dallas seeks an experienced Utilization Review RN for weekend PRN shifts. You will conduct medical necessity reviews for acute care services and collaborate with physicians to determine appropriate levels of care.

Strong knowledge of evidence-based guidelines and Epic CCM is preferred. Requires an active Texas RN license and 5 years of experience including 2 years in clinical settings and 3 years in utilization review.

Qualifications

• Graduate of accredited nursing program and holds an active unrestricted RN license in the State of Texas.
• 5 years experience including 2 years clinical experience and minimum 3 years of recent utilization review experience.
• Prior experience with Epic CCM is preferred.

Responsibilities

• Collaborates with the Central Scheduling Department to provide accurate and complete clinical information for authorization.
• Conducts admission reviews for Medicare and Medicaid beneficiaries and private insurers.
• Communicates with admitting physicians when documentation does not support hospital level of care.
• Keeps current on regulatory changes affecting delivery or reimbursement of acute care services.
• Performs reviews within department policies and meets quality standards.

Skills

Utilization review

Clinical experience

Communication with physicians

Education

RN license in Texas

Tools

Epic CCM

Job description

UT Southwestern Medical Center in Dallas seeks an experienced Utilization Review RN for weekend PRN shifts. You will conduct medical necessity reviews for acute care services and collaborate with physicians to determine appropriate levels of care.

Strong knowledge of evidence-based guidelines and Epic CCM is preferred. Requires an active Texas RN license and 5 years of experience including 2 years in clinical settings and 3 years in utilization review.