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Job ID

2147483647

Req. No

70055272

Job Title

Utilization Review Coordinator Case Management FT/40 HRS

Market

CHRISTUS St. Vincent

Category

General Operations

Travel

1-10%

Facility

Not Defined

Address

490A West Zia Rd
Santa Fe, NM  87505
USView Other Locations

Type

Full Time

Apply Now Utilization Review Coordinator Case Management FT/40 HRS Job in Santa Fe

Registered Nurse uses approved screening criteria (Milliman®/Interqual®/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Actively involved in management of inpatient observation patients. Provides consultative role as utilization management nurse to clinical and non-clinical departments. Documents objective findings against approved indicators. Assists with retrospective reviews and medical necessity denials per communication with third party payors. Follows UM policies and procedures and assists with continually improving the quality and effectiveness of the utilization management program at CSVRMC.

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