Job Attributes

Work Schedule/Shift

Not Available

Job ID

5000387529906

Req. No

70028655

Job Title

RN Utilization Review

Region

CHRISTUS System Office

Category

Registered Nurse (RN)

Division

Not Defined

Company

CHRISTUS Health

Travel

1-10%

Facility

Corp USFHP-55100

Address

919 Hidden Ridge
Irving, TX  75038
US

Type

Full Time

Apply Now RN Utilization Review Job in Irving

  • This position is responsible for analyzing clinical information submitted by medical providers to evaluate the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Is responsible for clinical review of all requested services for appropriateness based on clinical criteria. Performs selected member calls to address post hospital discharge services, ongoing durable medical equipment usage and other telephonic follow up identified by UM/CM Management.
  • This position will facilitate with negotiations for out of network care.

Position Qualifications:

  • Education/Skills:
    • Graduate of an accredited Registered Nursing Program, Bachelor Degree preferred
    • Basic Knowledge of computer systems
    • Good typing skills
    • Excellent customer service skills
    • Excellent negotiation skills
  • Experience
    • Minimum of three years diverse clinical experience as RN
    • Minimum of two years case management and/or utilization review experience
  • Licenses, Registrations, or Certifications:
    • Current/Active Texas RN Licensure
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