Remote RN - Utilization Review & Case Management

Oracle Corporation; El Paso (TX); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) with employer match

Generous paid time off

Career development opportunities

Health savings accounts

Job summary

Tenet Healthcare’s Hospitals of Providence in El Paso is seeking a Registered Nurse (RN) for Utilization Review. The role focuses on medical necessity screening, payer coordination, and ensuring appropriate care levels. Requires Texas RN license and 2 years acute care experience with 1 year in utilization review.

Graduate of an accredited nursing program is required; a BSN is preferred. The job offers professional growth and a comprehensive benefits package, reflecting Tenet’s commitment to

Qualifications

• Education: Graduate of an accredited school of nursing.
• Experience: 2 years of acute hospital or behavioral health patient care with at least 1 year utilization review in acute hospital or payer setting.

Responsibilities

• Provide accurate medical necessity screening and submission for Physician Advisor review.
• Secure and document authorization for services from payers.
• Manage concurrent disputes and collaborate with payers, physicians, and staff.
• Maintain timely, complete documentation in the Case Management system.
• Identify potentially avoidable days and report over/underutilization.

Education

Graduate of an accredited school of nursing

Bachelor's degree in nursing

Job description

Tenet Healthcare’s Hospitals of Providence in El Paso is seeking a Registered Nurse (RN) for Utilization Review. The role focuses on medical necessity screening, payer coordination, and ensuring appropriate care levels. Requires Texas RN license and 2 years acute care experience with 1 year in utilization review.

Graduate of an accredited nursing program is required; a BSN is preferred. The job offers professional growth and a comprehensive benefits package, reflecting Tenet’s commitment to