RN Utilization Management Reviewer – Health Plan

Cook Children's Health Care System; Fort Worth (TX); On-site; USD 80,000 - 100,000; Full time

Job summary

Cook Children's Health Care System seeks a Registered Nurse for Utilization Management/Episodic Case Manager (UM/ECM) in Fort Worth. The role coordinates care resources for CCHP members and works with the Department Manager to ensure timely, quality care.

Requirements: Associate Degree in Nursing (BSN preferred), Texas RN license, five years clinical experience, and two years in utilization or case management. Strong communication, critical thinking, organization, and customer service.

Qualifications

• RN with five years of clinical experience.
• Two years in utilization management or case management.
• Texas RN license in good standing.

Responsibilities

• Coordinate UM/episodic case reviews and care coordination.
• Communicate with providers and health plan staff to authorize services.

Skills

Oral and written communication

Critical thinking

Organization

Customer service

Education

Associate Degree in Nursing

BSN preferred

Job description

Cook Children's Health Care System seeks a Registered Nurse for Utilization Management/Episodic Case Manager (UM/ECM) in Fort Worth. The role coordinates care resources for CCHP members and works with the Department Manager to ensure timely, quality care.

Requirements: Associate Degree in Nursing (BSN preferred), Texas RN license, five years clinical experience, and two years in utilization or case management. Strong communication, critical thinking, organization, and customer service.