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,