Utilization Review RN: Health Plan Case Mgmt

CHRISTUS Health; Alamogordo (NM); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare provider in Alamogordo, New Mexico, seeks a Utilization Review Nurse to determine the appropriateness of care for patients. Responsibilities include performing various reviews to ensure hospital resource utilization and collaborating with clinical professionals. Ideal candidates should have 3-5 years of nursing experience and be proficient in Microsoft software. A vocational nursing degree is required, with RN licensure preferred. This full-time position offers a structured work schedule of five 8-hour days.

Qualifications

• 3 – 5 years of nursing experience preferred.
• Experience with Microsoft software required.
• Must have LVN license in the state of employment.

Responsibilities

• Determine clinical appropriateness of care provided to patients.
• Perform pre-admission, concurrent, and retrospective UM reviews.
• Communicate effectively with clinical professionals.

Skills

Excellent communication skills

Critical thinking

Clinical judgment

Problem-solving abilities

Education

Graduate of an accredited school of vocational nursing

Associate’s (ADN) or Bachelor’s (BSN) in Nursing

Tools

Microsoft Outlook

Microsoft Teams

Microsoft Word

Microsoft Excel

Job description

A leading healthcare provider in Alamogordo, New Mexico, seeks a Utilization Review Nurse to determine the appropriateness of care for patients. Responsibilities include performing various reviews to ensure hospital resource utilization and collaborating with clinical professionals. Ideal candidates should have 3-5 years of nursing experience and be proficient in Microsoft software. A vocational nursing degree is required, with RN licensure preferred. This full-time position offers a structured work schedule of five 8-hour days.