Senior RN - Utilization Review Leader

Baylor Scott & White Health; Irving (TX); On-site; USD 90,000 - 120,000; Full time

Job summary

Baylor Scott & White Health is seeking an experienced supervisor to oversee the Utilization Review team of RNs. You will guide daily processes, research denials, and ensure adherence to criteria.

This role requires strong leadership, mentoring, and cross-functional coordination with Medical Director and Care Coordination to optimize patient care and resource use. The ideal candidate has a solid background in discharge planning, case management, and UR workflows, plus excellent written and verbal

Qualifications

• Associate’s degree in nursing is required.
• Four years of supervisory experience in utilization review or a closely related field preferred.
• Strong communication and mentoring skills are essential for leading a diverse team.

Responsibilities

• Supervise Utilization Review Department: assign tasks, monitor productivity, conduct quality reviews, and advise on appeals.
• Collect data for weekly reports to improve staff outcomes and quality metrics.
• Collaborate with Medical Director and Care Coordination when patients do not meet criteria.

Skills

Team supervision

Mentoring

Communication

Discharge planning

Case management

Utilization review

Education

Associate’s Degree in Nursing

Tools

Microsoft Office

Job description

Baylor Scott & White Health is seeking an experienced supervisor to oversee the Utilization Review team of RNs. You will guide daily processes, research denials, and ensure adherence to criteria.

This role requires strong leadership, mentoring, and cross-functional coordination with Medical Director and Care Coordination to optimize patient care and resource use. The ideal candidate has a solid background in discharge planning, case management, and UR workflows, plus excellent written and verbal