Utilization Review Nurse Job at Adecco, Houston, TX

NFhqY2lnaGFpcXZrelJlOFNhM0w2eFluMkE9PQ==
  • Adecco
  • Houston, TX

Job Description

Adecco Healthcare & Life Sciences is excited to collaborate with a healthcare organization in Houston, TX 77081 to recruit an (Onsite) Utilization Review RN for a full-time, direct hire opportunity in Houston, TX 77081.

*This is NOT a remote position*

What You'll Do:

  • Thoroughly evaluate patient medical records to assess the necessity and appropriateness of treatments and services.
  • Regularly audit medical records and healthcare practices to ensure compliance with federal, state, and local regulations.
  • Collaborate with physicians, nurses, and other healthcare professionals to gather essential information and recommend optimal care pathways.
  • Work with facilities to facilitate approvals and organize necessary peer reviews.
  • Communicate with insurance companies to effectively confirm coverage for recommended treatments and manage appeals or disputes.
  • Educate patients and their families on treatment options, explaining benefits and risks to empower informed decision-making.
  • Keep accurate, detailed records of evaluations, recommendations, and all communications regarding patient care and compliance.

What You’ll Need:

  • A Bachelor of Science in Nursing (BSN) is strongly preferred; candidates with an Associate Degree in Nursing (ADN) will also be considered.
  • Must hold an active and unrestricted Registered Nurse (RN) license.
  • A minimum of 2–3 years of hands-on clinical nursing experience or case management, ideally within an acute care setting.
  • At least 2–3 years of experience in medical coding is required.

Compensation:

  • $85,000-$110,000/annually

Job Tags

Full time, Local area,

Similar Jobs

Solomon Page

Regulatory Counsel Job at Solomon Page

Our client, a leading private equity firm with over $35 in AUM, wants to add a lawyer to their team in New York. They're seeking an attorney with at least three years' experience handling regulatory/compliance work for investment management clients and some exposure to...

Seneca Resources

Electrician Job at Seneca Resources

 ...Position Title: Journeyman Electrician Environment: 100% on-site Location: Atlanta, GA Position Status: Direct Hire Pay rate: $75,000 In this role you will be working in an industrial manufacturing environment responsible for the installation, maintenance... 

ACL Digital

Aircraft Mechanic Job at ACL Digital

 ...Aircraft Mechanic Manassas, VA Job Description: We are seeking a highly experienced and skilled A&P Technician for the Saab 340 platform. The ideal candidate will have 2 to 5 years of experience working with Saab 340 aircraft and will be responsible support... 

Adams Robinson

Contract Administrator Job at Adams Robinson

 ...has a dedicated team with over 900 years of collective experience in the industry. Role Description We are seeking a Contract Administrator to become a part of our Team! This is a full-time on-site role for a Contract Administrator located in Mooresville, NC... 

MMP Staffing Services

Licensed Master Social Worker Job at MMP Staffing Services

 ...MMP Staffing is currently seeking a Licensed Master Social Worker (LMSW) to provide comprehensive social work services in support of a well-known organization. As an LMSW, you will play a key role in addressing the social and emotional needs of individuals and families...