AUSTIN TX Utilization Review RN

Bracane Company • Dallas, TX

3d • $35 - $40 • Onsite

About The Position

Bracane Company is seeking a dedicated and detail-oriented Utilization Review RN to join our team in Austin, TX. This is an exciting opportunity for a clinical professional to make a meaningful impact by ensuring patients receive the right care at the right time. If you're passionate about healthcare quality and patient advocacy, we want to hear from you!

Requirements

• Active and unrestricted RN license in the state of Texas
• Minimum 2-3 years of clinical nursing experience required
• Familiarity with InterQual or Milliman clinical criteria
• Strong knowledge of medical terminology, coding, and payer guidelines
• Excellent analytical, communication, and critical thinking skills
• Ability to work independently and manage a high-volume caseload efficiently

Nice To Haves

• Prior utilization review, case management, or managed care experience strongly preferred

Responsibilities

• Conduct utilization review assessments to evaluate medical necessity and appropriateness of care
• Perform concurrent, prospective, and retrospective reviews of patient cases
• Collaborate with physicians, case managers, and healthcare teams to coordinate patient care plans
• Apply evidence-based clinical criteria (e.g., InterQual, Milliman) to support review decisions
• Document and communicate review findings accurately and in a timely manner
• Identify opportunities for care improvement and ensure compliance with payer guidelines
• Support denial management and appeals processes as needed

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level