RN Utilization Management Clinician

University Health; Boerne (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

University Health is seeking a skilled Registered Nurse to join our care coordination team in Texas. This role focuses on ensuring access to necessary health services and coordinating care across the continuum to optimize outcomes.

Responsibilities include resource allocation, quality and cost management for members, interfacing with primary care physicians, families, and community resources, and collaborating with a multidisciplinary team to plan effective discharge and educational needs.

Qualifications

• Registered Nurse (RN) licensure in Texas required.
• Minimum three years nursing or related experience in acute care/quality management/managed care.
• Basic knowledge of Medicaid/Medicare and community resources.

Responsibilities

• Oversee allocation of resources, cost and quality of health care for members.
• Coordinate care between the primary care physician, family, community resources and member.
• Coordinate care across the health care continuum while monitoring benefit utilization.
• Collaborate with a multidisciplinary health care team to identify educational and discharge needs.

Skills

Care coordination

Resource management

Quality improvement

Case management

Education

RN licensure (TX)

BSN preferred

Master's degree preferred

Tools

InterQual criteria

ICD/CPT coding knowledge

Job description

University Health is seeking a skilled Registered Nurse to join our care coordination team in Texas. This role focuses on ensuring access to necessary health services and coordinating care across the continuum to optimize outcomes.

Responsibilities include resource allocation, quality and cost management for members, interfacing with primary care physicians, families, and community resources, and collaborating with a multidisciplinary team to plan effective discharge and educational needs.