Job Description

Adecco Healthcare & Life Sciences is excited to collaborate with a healthcare organization in Houston, TX 77081 to recruit an (Onsite) Utilization Review RN for a full-time, direct hire opportunity in Houston, TX 77081.

*This is NOT a remote position*

What You'll Do:

• Thoroughly evaluate patient medical records to assess the necessity and appropriateness of treatments and services.
• Regularly audit medical records and healthcare practices to ensure compliance with federal, state, and local regulations.
• Collaborate with physicians, nurses, and other healthcare professionals to gather essential information and recommend optimal care pathways.
• Work with facilities to facilitate approvals and organize necessary peer reviews.
• Communicate with insurance companies to effectively confirm coverage for recommended treatments and manage appeals or disputes.
• Educate patients and their families on treatment options, explaining benefits and risks to empower informed decision-making.
• Keep accurate, detailed records of evaluations, recommendations, and all communications regarding patient care and compliance.

What You’ll Need:

• A Bachelor of Science in Nursing (BSN) is strongly preferred; candidates with an Associate Degree in Nursing (ADN) will also be considered.
• Must hold an active and unrestricted Registered Nurse (RN) license.
• A minimum of 2–3 years of hands-on clinical nursing experience or case management, ideally within an acute care setting.
• At least 2–3 years of experience in medical coding is required.

Compensation:

• $85,000-$110,000/annually

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