Utilization Review Nurse - RN (WHWC)

{
  "content_hash": "2b47f79d18c51a1f2c979b4bf52a258dfc8b271d76058eb9fe78db093daaf4b9",
  "source_hash": "5a902cae1531ba5c56d3aa3e9f7393a484bf566ede2d7d89cbf06abc1fb9bbeb",
  "last_changed_at": "2026-06-06T11:56:43.352Z",
  "active_status": "active"
}

{
  "language": "en",
  "location": {
    "raw": "San Antonio, TX, US, San Antonio, TX",
    "city": "San Antonio",
    "region": "TX",
    "country": "United States",
    "is_remote": false,
    "confidence": 0.95
  },
  "salary_max": 94664,
  "salary_min": 74246,
  "inferred_at": "2026-06-06T11:56:43.318Z",
  "launch_scope": {
    "reason": "english_us_canada",
    "included": true,
    "language": "en",
    "location": {
      "raw": "San Antonio, TX, US, San Antonio, TX",
      "city": "San Antonio",
      "region": "TX",
      "country": "United States",
      "is_remote": false,
      "confidence": 0.95
    },
    "countries": [
      "United States"
    ]
  },
  "remote_policy": null,
  "salary_period": "year",
  "workplace_type": null,
  "salary_currency": "USD"
}

{}

{
  "detail": {
    "links": [],
    "itemID": "9201191091380_1",
    "postDate": "2026-05-28T08:11:00.000-04:00",
    "payGradeRange": {
      "maximumRate": {
        "amountValue": 94664,
        "currencyCode": "USD"
      },
      "minimumRate": {
        "amountValue": 74246,
        "currencyCode": "USD"
      }
    },
    "workLevelCode": {
      "shortName": "Non-Exempt Full-Time"
    },
    "customFieldGroup": {
      "codeFields": [
        {
          "nameCode": {
            "codeValue": "SalaryType"
          },
          "codeValue": "AN",
          "shortName": "Annually"
        },
        {
          "nameCode": {
            "codeValue": "SalaryRangeType"
          },
          "codeValue": "RANGE",
          "shortName": "RANGE"
        }
      ],
      "dateFields": [
        {
          "nameCode": {
            "codeValue": "PostingDate"
          },
          "dateValue": "2026-05-28T08:11Z"
        },
        {
          "nameCode": {
            "codeValue": "CurrentServerDateTime"
          },
          "dateValue": "2026-06-06T07:56Z"
        }
      ],
      "numberFields": [
        {
          "numberValue": 0,
          "categoryCode": {
            "codeValue": "ApplicantCount"
          }
        },
        {
          "categoryCode": {
            "codeValue": "AwardAmount"
          }
        }
      ],
      "stringFields": [
        {
          "nameCode": {
            "codeValue": "ExternalJobID"
          },
          "stringValue": "591881"
        },
        {
          "nameCode": {
            "codeValue": "CareerCenterRefId"
          }
        },
        {
          "nameCode": {
            "codeValue": "GuidelineOid"
          }
        },
        {
          "nameCode": {
            "codeValue": "CurrencySymbolOrCode"
          }
        },
        {
          "nameCode": {
            "codeValue": "HomeDepartment"
          },
          "stringValue": ""
        },
        {
          "nameCode": {
            "codeValue": "JobClass"
          },
          "stringValue": "Contributor"
        },
        {
          "nameCode": {
            "codeValue": "SalaryRange"
          },
          "stringValue": "74246.00 To 94664.00 (USD) Annually"
        }
      ],
      "indicatorFields": [
        {
          "nameCode": {
            "codeValue": "PriortyStatusFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "InternalPostingFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "MinValue"
          },
          "indicatorValue": true
        },
        {
          "nameCode": {
            "codeValue": "IsVsidApplicable"
          },
          "indicatorValue": true
        },
        {
          "nameCode": {
            "codeValue": "IsSassDlReqForExtPostFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "IsSassDlReqForIntPostFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "IsMonetaryFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "IsNonMonetaryFlag"
          },
          "indicatorValue": false
        }
      ]
    },
    "requisitionTitle": "Utilization Review Nurse - RN (WHWC)",
    "clientRequisitionID": "1576",
    "organizationalUnits": [],
    "postingInstructions": [],
    "additionalProperties": {},
    "requisitionLocations": [
      {
        "address": {
          "cityName": "San Antonio",
          "postalCode": "78211",
          "countrySubdivisionLevel1": {
            "codeValue": "TX"
          }
        },
        "nameCode": {
          "shortName": " San Antonio, TX, US"
        },
        "aliasNames": []
      }
    ],
    "screeningRequirements": [],
    "requisitionDescription": "<div><p data-pasted=\"true\"><strong>Position Summary</strong></p><p>The Utilization Review Nurse (RN) supports care coordination by reviewing clinical documentation, evaluating medical necessity, and facilitating communication between providers and care teams to ensure appropriate, timely, and patient-centered care.&nbsp;</p><p><strong>&nbsp;</strong></p><p><strong>Scope and Impact</strong></p><p>This role impacts patient outcomes across the care continuum by ensuring appropriate utilization of healthcare services, supporting referral processes, and promoting adherence to care coordination and patient-centered medical home principles.</p><p><strong>&nbsp;</strong></p><p><strong>Decision Making Authority</strong></p><p>Exercises clinical judgment in reviewing patient records, determining appropriateness of care, and identifying next steps within established guidelines and protocols. Escalates complex cases as needed.</p><p><strong>&nbsp;</strong></p><p><strong>Interactions / Working Relationships</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Internal: Care Coordination team (RN/LVN/MA), Patient Referral Coordinators, primary care providers&nbsp;</li><li style=\"margin-left:0in;\">External: Specialty providers, physician offices, multidisciplinary care teams&nbsp;</li><li style=\"margin-left:0in;\">Frequent communication with clinics and external partners to coordinate patient care and referrals&nbsp;</li></ul></div><p>.</p><p><strong>&nbsp;</strong></p><p><strong>Essential Duties and Responsibilities</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\"><strong>30%</strong> Review patient records, referral notes, and treatment plans to determine medical necessity and appropriate level of care&nbsp;</li><li style=\"margin-left:0in;\"><strong>15%</strong> Coordinate with specialty providers and internal teams to ensure continuity of care and timely processing of referrals&nbsp;</li><li style=\"margin-left:0in;\"><strong>10%</strong> Enter, maintain, and document clinical information in electronic health record (EHR) and medical management systems&nbsp;</li><li style=\"margin-left:0in;\"><strong>10%</strong> Process pre-authorizations and diagnostic orders in collaboration with Patient Referral Coordinators&nbsp;</li><li style=\"margin-left:0in;\"><strong>10%</strong> Communicate patient status updates, appointment scheduling, and follow-up care with clinics and providers&nbsp;</li><li style=\"margin-left:0in;\"><strong>10%</strong> Provide patient and family education regarding conditions, treatments, and care plans&nbsp;</li><li style=\"margin-left:0in;\"><strong>5%</strong> Ensure compliance with HIPAA regulations and organizational policies&nbsp;</li><li style=\"margin-left:0in;\"><strong>5%</strong> Promote patient-centered medical home principles and support care coordination initiatives&nbsp;</li><li style=\"margin-left:0in;\"><strong>5%</strong> Participate in multidisciplinary collaboration and case consultation&nbsp;</li><li style=\"margin-left:0in;\"><strong>Other:</strong> Perform additional duties as assigned&nbsp;</li></ul></div><p><br></p><p><strong>&nbsp;</strong></p><p><strong>Supervisory or Leadership Responsibilities</strong></p><p>This position does not supervise others.</p><p style=\"margin-left:0in;\"><strong>&nbsp;</strong></p><p style=\"margin-left:0in;\"><strong>Qualifications</strong></p><div style=\"margin-left:0in;\"><ul><li style=\"margin-left:0in;\">Minimum Qualifications (Required)</li><li style=\"margin-left:0in;\">Education: Graduate of an accredited nursing program&nbsp;</li><li style=\"margin-left:0in;\">Licenses/Certifications: Active Registered Nurse (RN) license in the State of Texas&nbsp;</li><li style=\"margin-left:0in;\">Experience: Minimum of three (3) years of RN experience&nbsp;</li></ul></div><p style=\"margin-left:.25in;\"><strong>Preferred Qualifications</strong></p><div style=\"margin-left:0in;\"><ul><li style=\"margin-left:0in;\">Bachelor of Science in Nursing (BSN)&nbsp;</li><li style=\"margin-left:0in;\">Experience in case management, care coordination, or acute care settings&nbsp;</li><li style=\"margin-left:0in;\">Bilingual (English/Spanish) proficiency&nbsp;</li></ul></div><p style=\"margin-left:.5in;\"><strong>&nbsp;</strong></p><p style=\"margin-left:.25in;\"><strong>Knowledge, Skills, and Abilities (KSAs)</strong></p><div style=\"margin-left:0in;\"><ul><li style=\"margin-left:0in;\">Strong clinical assessment and critical thinking skills&nbsp;</li><li style=\"margin-left:0in;\">Effective communication and interpersonal skills&nbsp;</li><li style=\"margin-left:0in;\">Ability to multitask and manage multiple referrals simultaneously&nbsp;</li><li style=\"margin-left:0in;\">Strong organizational skills and attention to detail&nbsp;</li><li style=\"margin-left:0in;\">Knowledge of medical terminology and clinical documentation standards&nbsp;</li><li style=\"margin-left:0in;\">Ability to work independently and collaboratively in a fast-paced environment&nbsp;</li></ul></div><p style=\"margin-left:.5in;\"><strong>&nbsp;</strong></p><p style=\"margin-left:.25in;\"><strong>Language Skills</strong></p><div style=\"margin-left:0in;\"><ul><li style=\"margin-left:0in;\">Required: English proficiency&nbsp;</li><li style=\"margin-left:0in;\">Preferred: Spanish proficiency<strong>&nbsp;</strong></li></ul></div><p style=\"margin-left:.5in;\"><strong>&nbsp;</strong></p><p style=\"margin-left:.25in;\"><strong>Technology and Tools</strong></p><div style=\"margin-left:0in;\"><ul><li style=\"margin-left:0in;\">Electronic Health Records (EHR) systems&nbsp;</li><li style=\"margin-left:0in;\">Medical management/referral systems&nbsp;</li><li style=\"margin-left:0in;\">Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)&nbsp;</li></ul></div><p style=\"margin-left:.5in;\"><strong>&nbsp;</strong></p><p style=\"margin-left:.25in;\"><strong>Work Environment and Physical Demands</strong></p><div style=\"margin-left:0in;\"><ul><li style=\"margin-left:0in;\">Work setting: Office/clinical environment with potential patient interaction&nbsp;</li><li style=\"margin-left:0in;\">Travel: May require local travel; valid driver&rsquo;s license and insurance required&nbsp;</li><li style=\"margin-left:0in;\">Physical demands: Standing, walking, bending, sitting for extended periods; ability to lift up to 25 lbs</li></ul></div></div>\n",
    "sponsoredVisaTypeCodes": []
  },
  "list_job": {
    "links": [],
    "itemID": "9201191091380_1",
    "postDate": "2026-05-28T08:11:00.000-04:00",
    "payGradeRange": {
      "maximumRate": {
        "amountValue": 94664,
        "currencyCode": "USD"
      },
      "minimumRate": {
        "amountValue": 74246,
        "currencyCode": "USD"
      }
    },
    "workLevelCode": {
      "shortName": "Non-Exempt Full-Time"
    },
    "customFieldGroup": {
      "codeFields": [
        {
          "nameCode": {
            "codeValue": "SalaryType"
          },
          "codeValue": "AN",
          "shortName": "Annually"
        },
        {
          "nameCode": {
            "codeValue": "SalaryRangeType"
          },
          "codeValue": "RANGE",
          "shortName": "RANGE"
        }
      ],
      "dateFields": [
        {
          "nameCode": {
            "codeValue": "PostingDate"
          },
          "dateValue": "2026-05-28T08:11Z"
        },
        {
          "nameCode": {
            "codeValue": "CurrentServerDateTime"
          },
          "dateValue": "2026-06-06T07:56Z"
        }
      ],
      "numberFields": [
        {
          "numberValue": 0,
          "categoryCode": {
            "codeValue": "ApplicantCount"
          }
        },
        {
          "categoryCode": {
            "codeValue": "AwardAmount"
          }
        }
      ],
      "stringFields": [
        {
          "nameCode": {
            "codeValue": "ExternalJobID"
          },
          "stringValue": "591881"
        },
        {
          "nameCode": {
            "codeValue": "CareerCenterRefId"
          }
        },
        {
          "nameCode": {
            "codeValue": "GuidelineOid"
          }
        },
        {
          "nameCode": {
            "codeValue": "CurrencySymbolOrCode"
          }
        },
        {
          "nameCode": {
            "codeValue": "HomeDepartment"
          },
          "stringValue": ""
        },
        {
          "nameCode": {
            "codeValue": "JobClass"
          },
          "stringValue": "Contributor"
        },
        {
          "nameCode": {
            "codeValue": "SalaryRange"
          },
          "stringValue": "74246.00 To 94664.00 (USD) Annually"
        }
      ],
      "indicatorFields": [
        {
          "nameCode": {
            "codeValue": "PriortyStatusFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "InternalPostingFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "MinValue"
          },
          "indicatorValue": true
        },
        {
          "nameCode": {
            "codeValue": "IsVsidApplicable"
          },
          "indicatorValue": true
        },
        {
          "nameCode": {
            "codeValue": "IsSassDlReqForExtPostFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "IsSassDlReqForIntPostFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "IsMonetaryFlag"
          },
          "indicatorValue": false
        },
        {
          "nameCode": {
            "codeValue": "IsNonMonetaryFlag"
          },
          "indicatorValue": false
        }
      ]
    },
    "requisitionTitle": "Utilization Review Nurse - RN (WHWC)",
    "clientRequisitionID": "1576",
    "organizationalUnits": [],
    "postingInstructions": [],
    "additionalProperties": {},
    "requisitionLocations": [
      {
        "address": {
          "cityName": "San Antonio",
          "postalCode": "78211",
          "countrySubdivisionLevel1": {
            "codeValue": "TX"
          }
        },
        "nameCode": {
          "shortName": " San Antonio, TX, US"
        },
        "aliasNames": []
      }
    ],
    "screeningRequirements": [],
    "sponsoredVisaTypeCodes": []
  },
  "detail_meta": {
    "url": "https://workforcenow.adp.com/mascsr/default/careercenter/public/events/staffing/v1/job-requisitions/591881?cid=8cda4e42-a6a7-47a4-8fc6-ad641a3a00ec&ccId=19000101_000001&lang=en_US&locale=en_US",
    "http_status": 200,
    "content_type": "application/json;charset=UTF-8",
    "response_bytes": 11517
  },
  "detail_errors": []
}