Utilization Review RN: Inpatient Care & Appeals

Dallas Behavioral Healthcare Hospital; DeSoto (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

Dallas Behavioral Healthcare Hospital is seeking a Utilization Review RN to manage authorization for inpatient admissions and services. You will work with insurance and managed care to obtain approvals and monitor the review process to ensure patients access necessary benefits.

This on-site role requires RN licensure in Texas and a clinical background in acute psychiatric care. You will conduct admission, concurrent, and retrospective reviews, prepare appeals, and maintain UR records while

Qualifications

• Clinical degree such as nursing or related healthcare field is required.
• Texas RN license required.
• Two years clinical experience in psychiatry or related setting preferred.
• Knowledge of managed care environment and admission/continued stay criteria.
• Pass background check, drug screen, and provide positive references.

Responsibilities

• Conducts admission reviews.
• Conducts concurrent and extended stay reviews.
• Prepares and submits appeals to third party payors.
• Maintains appropriate records of the Utilization Review Department.
• Performs related duties as requested.
• Upholds the Organization's ethics and customer service standards.
• This position is on-site and NOT a remote position.

Skills

RN License

Medical Terminology

Time Management

Attention to Detail

Communication Skills

Discharge Planning

Education

Clinical degree in Nursing or related healthcare field

Related experience welcomed

Job description

Dallas Behavioral Healthcare Hospital is seeking a Utilization Review RN to manage authorization for inpatient admissions and services. You will work with insurance and managed care to obtain approvals and monitor the review process to ensure patients access necessary benefits.

This on-site role requires RN licensure in Texas and a clinical background in acute psychiatric care. You will conduct admission, concurrent, and retrospective reviews, prepare appeals, and maintain UR records while