Registered Nurse (RN) - Utilization Review
Compensation
Pay not listed
The week · per this posting
Ask the employer about the pay range, the work setting, weekend coverage and time off.
Job Description
Job Shift: Days
Job Type: Full Time
The individual in this position is responsible to facilitate effective resource coordination to help patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination.
The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity. This position manages medical necessity process for accurate and timely payment for services which may require negotiation with a payer on a case-by-case basis.
This position integrates national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention; Coordination with payers to authorize appropriate level of care and length of stay for medically necessary services required for the patient; Compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy; and Education provided to payers, physicians, hospital/office staff, and ancillary departments related to covered services and administration of benefits.
Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients' lives while enjoying a supportive work environment that fosters professional growth and work-life balance. Ready to be a vital part of our mission? Apply today and bring your passion for nursing to a place where it truly matters!
At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
- Medical, dental, vision, and life insurance
- 401(k) retirement savings plan with employer match
- Generous paid time off
- Career development and continuing education opportunities
- Health savings accounts, healthcare & dependent flexible spending accounts
- Employee Assistance program, Employee discount program
- Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance
Note: Eligibility for benefits may vary by location and is determined by employment status
The Hospitals of Providence have faithfully been serving our community since
1902. Generations of families have chosen our hospitals to be a steward of health in the El Paso community. Our five hospitals include a childrens hospital committed to providing the care patients need, when they need it. Today, the Hospitals of Providence are comprised of our region's most trusted hospitals, each dedicated to meeting our families specific healthcare needs. Join our team!
Key Responsibilities
The Registered Nurse facilitates effective resource coordination to ensure patients receive care at the appropriate level based on medical necessity. They manage the medical necessity process to ensure accurate payment and coordinate with payers to authorize services and length of stay.
Requirements
Candidates must be a graduate of an accredited school of nursing with a current RN license and at least 2 years of acute hospital or behavioral health experience. A minimum of 1 year of utilization review experience in an acute hospital or managed care setting is also required.
Qualifications
- Experience
- 2+ years of experience
Key Skills
Utilization Review — Registered Nurse Career Context
Of the 50 active Utilization Review listings this role was benchmarked against, 24% are remote, 56% have no call, 74% require no weekends.
The cost-of-living index for Texas is 97.1 (US average = 100; BEA Regional Price Parities (2024)). 57.7% of Texas clinicians report burnout symptoms in WeekdayDoc's Burnout Index (2026-01 data).
Location & Logistics
Texas has no state income tax, which can significantly increase take-home pay compared to high-tax states.
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