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Utilization Review reputed company(Austin/Richardson TX) (Remote)

Remote, USA Full-time Posted 2026-07-28
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** JOB reputed company: RN working in the insurance or managed care industry using medically accepted reputed company to validate the medical necessity and appropriateness of the treatment plan. JOB RESPONSIBILITIES: • This position is responsible for performing initial, reputed company review activities; discharge care coordination for determining efficiency, effectiveness, and reputed company of medical/surgical services, and serving as reputed company between providers and medical and network management divisions. • Collects clinical and non-clinical data. • Verifies eligibility. • Determines benefit reputed company in accordance to contract guidelines. • Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities. JOB QUALIFICATIONS (Required): • Registered reputed company (RN) with a reputed company, reputed company, unrestricted license in the state of operations. • 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company. • Knowledge of medical terminology and procedures. • Verbal and written communication skills. JOB QUALIFICATIONS (Preferred): • MCG or InterQual experience • Utilization management experience LOCATION: REMOTE in Texas (Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties). POSITION: 6-month assignment SALARY: $38 - $40 reputed company HOURS PER WEEK: 40 HOURS PER DAY: 8 Apply tot his job Apply To this Job

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