RN Utilization & Care Coordination Specialist

University Health; San Antonio (TX); On-site; USD 70,000 - 100,000; Full time

Job summary

University Health seeks an experienced RN Case Manager to oversee resource allocation, cost and quality of care for CFHP members. You will coordinate care across the primary care physician, family, resources, and the member to ensure efficient access to services across the care continuum.

Required is a TX RN license with BSN/MSN preferred and at least 3 years in nursing, acute care, or managed care. Knowledge of Medicaid/Medicare, InterQual, DRG/ICD/CPT coding is desirable.

Qualifications

• Active RN license in TX is required.
• BSN or MSN preferred for advanced scope.
• Minimum 3 years in nursing, acute care, quality management or managed care.

Responsibilities

• Oversee allocation of resources, cost and quality of care for members.
• Coordinate care among primary care physician, family, and member across continuum.
• Collaborate with multi-disciplinary team to identify educational and discharge needs.

Skills

InterQual criteria

DRG coding

ICD coding

CPT coding

Education

RN

BSN or MSN preferred

Job description

University Health seeks an experienced RN Case Manager to oversee resource allocation, cost and quality of care for CFHP members. You will coordinate care across the primary care physician, family, resources, and the member to ensure efficient access to services across the care continuum.

Required is a TX RN license with BSN/MSN preferred and at least 3 years in nursing, acute care, or managed care. Knowledge of Medicaid/Medicare, InterQual, DRG/ICD/CPT coding is desirable.