Utilization Management Nurse II: Care Approvals & Optimization

CHRISTUS Health; Longview (TX); Presencial; USD 80 000 - 100 000; Tempo integral

Resumo da oferta

CHRISTUS Health in Texas seeks a Utilization Management Nurse II to assess clinical appropriateness and optimize hospital resource use. The role includes pre-admission, concurrent, and retrospective reviews using established criteria and coordinating with payors and clinicians to obtain necessary certifications.

Candidates should demonstrate strong communication, critical thinking, and multitasking abilities in a fast-paced, regulated healthcare environment.

Qualificações

• RN license required or equivalent for state employment
• Excellent verbal and written communication skills
• Ability to multitask in a fast-paced regulatory environment

Responsabilidades

• Meets expectations of OneCHRISTUS Competencies: Leader of Self, Others, or Leaders.
• Apply clinical judgment to assess information and determine medical necessity and level of care.
• Coordinate identification of patient status and ensure appropriate documentation supports level of care.
• Collaborate with physicians and treatment teams to obtain necessary documentation.
• Facilitate patient care progression and communicate with payors for certification of services.
• Review regulations and ensure compliance with HIPAA, CMS, and Joint Commission guidelines.

Conhecimentos

Communication skills

Critical thinking

Multitasking

Interdisciplinary collaboration

Formação académica

Graduate of accredited School of Nursing

Descrição da oferta de emprego

CHRISTUS Health in Texas seeks a Utilization Management Nurse II to assess clinical appropriateness and optimize hospital resource use. The role includes pre-admission, concurrent, and retrospective reviews using established criteria and coordinating with payors and clinicians to obtain necessary certifications.

Candidates should demonstrate strong communication, critical thinking, and multitasking abilities in a fast-paced, regulated healthcare environment.