Inpatient Behavioral Health Utilization RN

University of Texas Southwestern Medical Center; Dallas (TX); Presencial; USD 90.000 - 120.000; Tempo integral

Resumo da vaga

UT Southwestern Medical Center seeks an Inpatient Behavioral Health Utilization Management Nurse to perform prospective, concurrent, and retrospective utilization reviews for patients in a behavioral health hospital setting. The role collaborates with physicians and interdisciplinary teams to ensure medical necessity, authorization, and appropriate level of care.

The position requires five to eight years of inpatient psychiatric experience and an active Texas RN license, with responsibilities

Qualificações

• Graduate of accredited nursing program and holds an active unrestricted RN license in Texas.
• Five to eight years of clinical experience in an inpatient psychiatric setting.
• RN license in the State of Texas (unrestricted).

Responsabilidades

• Performs prospective, concurrent, and retrospective utilization reviews for inpatient behavioral health services.
• Completes pre-certification, admission authorization, re-certification, and retrospective reviews.
• Maintains documentation in the EMR and payer portals within established timeframes.
• Communicates with physicians, care teams, payers, and external reviewers to obtain and submit clinical information for authorization updates.
• Supports denial and appeal activities and coordinates with case management for barriers to utilization.

Formação

Graduate of accredited nursing program and active unrestricted RN license in Texas

Descrição da vaga

UT Southwestern Medical Center seeks an Inpatient Behavioral Health Utilization Management Nurse to perform prospective, concurrent, and retrospective utilization reviews for patients in a behavioral health hospital setting. The role collaborates with physicians and interdisciplinary teams to ensure medical necessity, authorization, and appropriate level of care.

The position requires five to eight years of inpatient psychiatric experience and an active Texas RN license, with responsibilities