Utilization Review Nurse – Onsite

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Job Details

Utilization Review Nurse – Onsite

Job Overview

Utilization Review Nurse – Onsite


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******Full Time - Permanent - Utilization Review Nurse - Onsite needed in northern Houston, TX area.

What are the requirements needed for this job?

  • Excellent written and verbal communication skills
  • Ability to communicate professionally with physicians and clients
  • Ability to multi-task and quickly adapt in a fast-paced office environment
  • Strong organizational skills with attention to detail
  • Ability to problem solve complex, multifaceted, situations
  • Experience with Microsoft products: Word, Excel, PowerPoint, Outlook
  • Education, training or professional experience in medical and/or clinical practice
  • Current RN license, without restrictions, a degree in nursing (RN) from an accredited college

What other skills/experience are we looking for?

  • 3-5 years of clinical nursing experience (preferred)
  • Prior experience in Utilization Management (preferred)
  • Knowledge of ODG, MTUS, Milliman Care Guidelines, InterQual (preferred)


  • 3-5 years experience in acute hospital direct care
  • 2-3 years experience in acute hospital case management, utilization management or discharge planning of complex medical/surgical cases
  • Proficient with use of InterQual, Milliman or other national recognized criteria
  • Strong analytical and organizational skills
  • Working knowledge and ability to apply professional standards of practice in work environment.
  • Knowledge of specific regulatory managed care and accreditation requirements
  • Computer proficiency

Education Required

  • Registered Nurse, 
  • BSN preferred

Additional Information


  • Must maintain current licensure in good standing during employment in Nursing
  • Certified in AHA BLS
  • Must obtain CEU’s in accordance with state requirements for licensure


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