Texas Licensed RN Utilization Review Manager

Job Summary

A company is looking for a RN Utilization Review Manager to oversee utilization management processes and staff in a healthcare organization.

Key Responsibilities

• Conduct monthly audits of UM staff and coordinate clinical rounds
• Manage daily operations and ensure compliance with turnaround times for UM processes
• Support staff development and contribute to departmental goals and initiatives

Required Qualifications

• BSN degree with an active Texas RN license; MBA, MPH, MHA, or MSN preferred
• Two years of utilization management experience in a Managed Care environment
• Two years of supervisory or leadership experience
• Experience managing 10+ UM RNs and familiarity with Texas Medicaid, CHIP, and marketplace
• Moderate computer knowledge of MS Office applications