RN Case Management Leader – Utilization Review

Methodist Hospital for Surgery; Addison (TX); On-site; USD 80,000 - 100,000; Full time

Job summary

A healthcare institution in Addison, TX seeks an experienced Registered Nurse (RN) to oversee the Case Management team focusing on Utilization Review. Responsibilities include managing departmental operations, ensuring compliance with regulations, and improving care coordination. Candidates must have an RN license with a BSN and ideally hold a Case Management certification. This full-time position emphasizes effective communication, leadership, and critical thinking skills.

Qualifications

• Minimum of 3 years of previous case management experience in a hospital setting.
• Ability to be assertive with persuasive communication skills.
• Previous supervisory experience preferred.

Responsibilities

• Lead, mentor, and manage the small case management team.
• Oversee the utilization review process to ensure appropriate use of healthcare services.
• Facilitate seamless transitions of care across the continuum.

Skills

Effective communication

Critical thinking

Organizational skills

Teamwork

Leadership

Education

RN license with BSN

Certification in Case Management (CCM) or Utilization Review (ACM)

Tools

EPIC

MCG Indicia

InterQual

Milliman

Job description

A healthcare institution in Addison, TX seeks an experienced Registered Nurse (RN) to oversee the Case Management team focusing on Utilization Review. Responsibilities include managing departmental operations, ensuring compliance with regulations, and improving care coordination. Candidates must have an RN license with a BSN and ideally hold a Case Management certification. This full-time position emphasizes effective communication, leadership, and critical thinking skills.