Texas Licensed Utilization Reviewer

Job Summary

A company is looking for a Utilization Reviewer 2 who will perform utilization reviews on workers' compensation treatment referrals.

Key Responsibilities

• Perform utilization review to assess the medical necessity of treatment plans
• Collaborate with healthcare providers and stakeholders to gather information for assessments
• Evaluate medical documentation for compliance with industry standards and communicate findings

Required Qualifications

• Bachelor's degree
• Registered Nurse (RN) with a valid license in the state of practice
• Minimum of 2 years of clinical experience or an advanced degree without experience
• Knowledge of medical terminology and healthcare guidelines
• Familiarity with relevant software and tools used in healthcare