Utilization Management Clinical RN

Texas Children's
Houston, TX
Job Description
Texas Children’s Health Plan is seeking a Utilization Management Clinical RN to provide precertification of inpatient and outpatient procedures, manage utilization, and ensure medical necessity. The role involves case review, clinical judgment, collaboration with medical and provider teams, and discharge planning. The position requires adherence to national standards and regulatory guidelines.

Requirements

  • Diploma in or associate’s degree in nursing or related field (Texas Board of Nursing approval required)
  • Bachelor’s degree in nursing preferred
  • RN license from Texas Board of Nursing
  • 3 years nursing experience
]]>