Utilization Review Coordinator Case Management Per Diem
CHRISTUS St. Vincent
490A West Zia Rd
Santa Fe, NM 87505
USView Other Locations
Share This Job On
Apply Now Utilization Review Coordinator Case Management Per Diem 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.